"Research design and strategy for studying psychological adjustment to cancer": Reply to Thomas.

The Andersen and Jochimsen (1985) investigation was conducted to determine the sexual functioning deficits and the relation between global sexual evaluation and adjustment in two related areas, the marital relationship and body image, for breast and gynecologic cancer patients. In response to Thomas's (1986) commentary, a discussion is provided of quasi-experimental designs, choice of appropriate comparison conditions, and separation of cancer, site, and treatment effects and their interactions in the study of psychological aspects of cancer adjustment. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions, beliefs about control, and adjustment to breast cancer.

Examined attributions for cancer and beliefs about control over cancer for their association with adjustment to breast cancer. 78 29–78 yr old females with breast cancer served as Ss. Ss were administered a battery of tests that included the Profile of Mood States, Rotter's Internal–External Locus of Control Scale, and the Rosenberg Self-Esteem Scale. Although 95% of the Ss made attributions for their cancer, no particular attribution (e.g., stress, diet) was associated with better adjustment. Analyses of attributions of responsibility for the cancer to the self, environment, another person, or chance yielded only a negative relation between adjustment and blaming another person. In contrast, both the belief that one could now control one's cancer and the belief that others (e.g., the physician) could now control the cancer were significantly associated with good adjustment. Of the different types of control, cognitive control was most strongly associated with adjustment, behavior control was less strongly associated with adjustment, and information control and retrospective control were unassociated with adjustment. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life after breast cancer: understanding women's health-related quality of life and sexual functioning

PURPOSE: To describe the health-related quality of life (HRQL), partner relationships, sexual functioning, and body image concerns of breast cancer survivors (BCS) in relation to age, menopausal status, and type of cancer treatment. PATIENTS AND METHODS: A cross-sectional sample of BCS in two large metropolitan areas was invited to participate in a survey study that included the following standardized measures: the RAND 36-Item Health Survey; the Centers for Epidemiologic Studies-Depression Scale (CES-D); the Dyadic Adjustment Scale (DAS); the Breast Cancer Prevention Trial (BCPT) Symptom Checklist; the Watts Sexual Functioning Questionnaire (WSFQ); and subscales from the Cancer Rehabilitation Evaluation System (CARES). RESULTS: Eight hundred sixty-four BCS completed the survey. RAND Health Survey scores were as good or better than those of healthy, age-matched women, and the frequency of depression was similar to general population samples. Marital/partner adjustment was similar to normal healthy samples, and sexual functioning mirrored that of healthy, age-matched postmenopausal women. However, these BCS reported higher rates of physical symptoms (eg, joint pains, headaches, and hot flashes) than healthy women. Sexual dysfunction occurred more frequently in women who had received chemotherapy (all ages), and in younger women who were no longer menstruating. In women > or = 50 years, tamoxifen therapy was unrelated to sexual functioning. CONCLUSION: BCS report more frequent physical and menopausal symptoms than healthy women, yet report HRQL and sexual functioning comparable to that of healthy, age-matched women. Nevertheless, some survivors still experience poorer functioning, and clinicians should inquire about common symptoms to provide symptomatic management or counseling for these women.     

Effectiveness of single therapists versus cotherapy teams in sex therapy.

Assigned 65 sexually dysfunctional couples to treatment by a single male therapist, a single female therapist, or a dual-sex cotherapy team. The male Ss in age ranged from 21 to 69 yrs; female Ss were aged 20 to 65 yrs. Mean duration of the Ss' relationships was 12.7 yrs. Treated dysfunctions included male erectile failure and premature ejaculation and female primary and secondary orgasmic dysfunction. Assessments of marital and sexual satisfaction and functioning were made at initial intake, at the start of therapy, immediately following therapy, and at a 3-mo follow-up. The assessment battery included the Sexual Interaction Inventory, a marriage inventory, patient global ratings, and measures of symptom remission. Repeated measures ANOVA and post hoc comparisons failed to reveal any differences in effectiveness of single therapists vs cotherapy teams. Furthermore, in cases treated by single therapists, a matching of sex of therapist with sex of the dysfunctional member of the couple did not lead to better outcome than for nonmatched cases. Overall, sex therapy was generally effective, although greater gains were shown in Ss' global ratings of satisfaction and in the psychometric measures of adjustment than in actual symptom remission. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support, life events, and depressive symptoms: A 1-year prospective study.

Examined associations between life events, social support, and depressive symptoms in a sample of 709 married women. Ss were administered the SCL-90, a life events scale, a social support scale, and a marital conflict scale in 1981 and again 1 yr later. For a sample of 473 Ss who initially were relatively asymptomatic and reported nonconflicted marital relationships, life events and social support were significant prospective predictors of depressive symptomatology (assessed 1 yr later). In contrast, identical analyses performed on the full, unselected sample yielded discrepant, likely misleading, results. The implications of these findings for the longitudinal study of dynamically interactive processes are discussed. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and parental adjustment to pediatric cancer.

Assessed the psychosocial adjustment of 107 23–58 yr old parents whose children had cancer using the Psychosocial Adjustment to Illness Scale. Ss whose child had died showed poorer adjustment than Ss whose child was in treatment or had completed treatment. Ss over 30 yrs of age showed better adjustment than younger Ss. Different patterns of association between 11 sources of social support and adjustment were found. Psychosocial adjustment of Ss with a child in treatment was correlated more frequently with perceived social support than for other Ss. Results suggest that particular attention should be paid to the psychosocial adjustment of young bereaved parents. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Type A behavior in employed women: Relation to work, marital, and leisure variables, social support, stress, tension, and health.

91 21–62 yr old women employed full-time were administered the Jenkins Activity Survey and a Type A (coronary prone) behavior scale by S. Haynes et al (see record 1979-33979-001). Information concerning various work and nonwork-related (e.g., marital relations and leisure activity) variables was obtained via questionnaire or interview. Type As had higher occupational levels and reported more demanding jobs and higher stress and tension than Type Bs. Type As and Bs did not differ in their reports of marital adjustment or in total hours spent in leisure activities. Type A behavior was related to both self-reported stress and tension—and for married women only, to poorer self-reported physical health. Social support from various sources was not related to Type A or B behavior. Type A was related to more reported stress and tension for Ss who felt they had many sources of support but not for Ss who did not perceive their having many sources of support. (51 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in life patterns and symptoms of low mood as reported by wives of severely brain-injured soldiers.

Tested hypotheses that (a) wives of brain-injured veterans would perceive greater changes in their family life 1 yr following their husbands' injury than wives of paraplegic veterans and (b) wives of brain-injured veterans would report more symptoms indicative of low mood than wives of paraplegics and controls. 27 Israeli wives (mean age, 26 yrs) whose husbands had fought in the Yom Kippur War 1 yr earlier responded to questions assessing family life, family interpersonal relations, marital roles, and disturbances in mood. Eight Ss had brain-injured husbands; 5 Ss had paraplegic husbands; and 14 Ss had uninjured husbands. Data support both hypotheses. Significant differences between groups appeared in each of the 4 major areas. It is suggested that future research consider "good adjustment" to the postwar return of paraplegic or brain-injured husbands. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sociometric status and adjustment of hospitalized disturbed children.

Investigated the relationship between the social status and adjustment of 38 7-16 yr. old psychiatric inpatients. Sociometric information was obtained by comparing the friendship choices of each S, and adjustment was measured by staff ratings and S's length of stay in the hospital. No relationship was found between sociometric status and Ss' age, IQ, diagnosis, or popularity with staff members. There was a tendency, however, for long-term Ss to have fewer friends than short-term Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problems in a study of the sexual response of women with cancer: Comment on Andersen and Jochimsen.

The present commentary criticizes Andersen and Jochimsen's (1985) article on the sexual functioning of women with gynecological cancer and breast cancer. Emphasis is on (a) choice of control group and implications for internal and external validity, (b) the role of nonspecific cancer treatments (chemotherapy, radiotherapy, surgery) vis-à-vis mediating variables (body image and marital difficulties), and (c) interpretation of data regarding sexual functioning. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual attitudes and self-reported behavior of congenitally disabled adults.

A 1–3 hr personal interview was conducted and a questionnaire was administered to 45 18–35 yr old physically disabled Ss. The questionnaire dealt with (a) attitudes towards pornography, masturbation, and other aspects of sexuality; (b) degree of personal interest in sex; and (c) the extent and form of Ss' intimate sexual behavior. Results indicate that while Ss tended to express liberal attitudes toward sexuality, they did not indicate a high degree of personal interest in sex. Nearly all of the Ss were unmarried, and over half had never had a serious relationship with the opposite sex or any intimate sexual experience. There were indications that many Ss were uninformed about sexual matters. Ss' negative attitudes toward sex could be attributed to restrictive living conditions and insufficient sex education and guidance. As a group, females expressed more conservative attitudes toward sexuality than did males. Findings suggest the need for reorientation on the part of parents, educators, and society toward recognizing and accepting the emotional and sexual needs of disabled persons. (French summary) (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment of adolescents to chronic disability.

Investigated the relationship between adolescents' adjustment to a chronic disability and 8 demographic and attitudinal variables. Adjustment was defined as the total positive score on the Tennessee Self-Concept Scale. Ss were 59 12–18 yr old females with idiopathic scoliosis and their mothers. Analysis identified the following 4 variables, in decreasing order, that correlated with the adjustment of adolescents to scoliosis: (a) adolescents' tendency toward the container-isolator end of B. A. Wright's (1960) theoretical continuum of coping responses to a physical disability as measured by an attitude toward disability test, (b) a dimension of maternal attitude toward disability as measured by a disability factor scale, (c) a dependency factor of maternal attitude toward females and persons with scoliosis as measured by a factor analyzed 70-item semantic differential scale, and (d) a maternal high self-concept factor from the semantic differential scale. Ss did not differ significantly from peers on the adjustment measure, and implications for treatment and rehabilitation are discussed. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Young adolescent cancer survivors and their parents: Adjustment, learning problems, and gender.

Investigated adjustment in 59 10–15 yr old long-term survivors of childhood cancer and their parents at 2 points 1 yr apart. Behavioral concerns, parental distress, anxiety, hopelessness, social support, and family functioning were assessed. Gender and the presence of learning problems were examined. The data indicated levels of adjustment that were near normative levels. However, gender differences were found, with male adolescents reporting low levels of anxiety and hopelessness. Those survivors with learning difficulties appeared particularly vulnerable with respect to long-term adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of emotional arousal on subsequent sexual arousal in men.

The effect of emotional arousal on subsequent sexual arousal was assessed in 14 18–34 yr old men. Ss initially viewed either 1 of 2 emotionally arousing videotapes (depression-and-anger or anxiety-and-anger producing) or a neutral videotape (a travelogue), each of which was followed by an erotic videotape. Sexual arousal was measured physiologically with a penile strain gauge. Although there were no differences in the level of sexual arousal during the antecedent emotionally arousing or neutral videotapes, sexual arousal during the subsequent erotic videotapes was differentially affected by them. Sexual arousal following the anxiety-and-anger videotape was greater than that following either the depression-and-anger videotape or the travelogue. Prior exposure to the travelogue resulted in greater sexual arousal than did the videotape producing depression and anger. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological impacts of sexual contact between therapists or other health care practitioners and their clients.

14 females who had had sexual contact with their therapists/psychiatrists (Group 1), 7 females who had had sexual contact with their health care practitioners (principally physicians [Group 2]), and 10 females who had received counseling services but had not engaged in sexual contact with therapists (Group 3) were compared by administering a questionnaire on self-esteem, depression, attitudes, beliefs about sexual contact, emotional effects of treatment, sexual attitudes, and psychosomatic and psychological symptoms. In addition, data were obtained from Ss, who were primarily aged 26–45 yrs, on (1) history of sexual victimization, (2) marital status of therapist/physician, (3) who initiated sexual contact, and (4) frequency of sexual contact. Results show that Ss in Group 1 had greater mistrust of and anger toward males and therapists and a greater number of psychological and psychosomatic symptoms following the cessation of therapy than did Ss in Group 3. Ss in Groups 1 and 2 did not differ in psychological impacts. Severity of impacts were significantly related to the magnitude of psychological and psychosomatic symptoms prior to treatment, prior sexual victimization, and the marital status of the therapist or health practitioner. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial adjustment following ostomy.

Examined a range of postsurgical adjustment difficulties in 131 adult ostomy patients. Ss reported experiencing a significant number of technical, emotional, social, marital/family, and sexual difficulties postsurgically. Technical and emotional difficulties were associated with problematic social and marital/family adjustment and impaired sexual functioning. Technical problems, emotional difficulties, and social problems were all associated with the S's perception of having received inadequate preparatory information. Marital/family and sexual maladjustment, on the other hand, were associated with low levels of perceived social support. Results support the biopsychosocial model of chronic illness proposed by G. L. Engel (see record 1978-01423-001). Clinical implications are discussed, as well as their relation to previous research on adjustment to stressful medical procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of female sexual dysfunction through symbolic modeling.

Presents an evaluation of treatment programs for women suffering from debilitating sexual anxiety. Attitudinal and behavioral indices of sexual adjustment and sexual anxiety, including a card sort, a sexual semantic differential, and the Bantler Heterosexual Behavior Hierarchy, were obtained from 22 21–39 yr old inorgasmic women to assess effects of individual and group graduated symbolic modeling through videotapes, with concurrent behavioral tasks as treatment procedures. All Ss had reported severe anxiety that precluded sexual enjoyment or activity. 16 Ss were randomly assigned to 2 groups receiving either individual or group treatment, which consisted of relaxation training followed by viewing 45 videotaped vignettes depicting graduated sexual behaviors. Five sessions were held twice weekly. The other Ss were subjected to identical measurement without treatment. Results show that significant decreases in anxiety and increases in behavioral and attitudinal measures were evidenced for both treatment groups; however, a trend toward greater improvement was observed for those receiving group treatment. Improvement remained stable through a 1-yr follow-up. Control Ss showed no improvement and trends toward deterioration. The treatment regimen appeared to produce positive changes in attitudinal, behavioral, and anxiety indices simultaneously. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Controlled prospective longitudinal study of women with cancer: II. Psychological outcomes.

The incidence and etiology of major life difficulties for women with survivable cancer were studied. Women with early stage cancer (n?=?65) were assessed after diagnosis but prior to treatment and reassessed at 4, 8, and 12 mo posttreatment. Two matched comparison groups, women diagnosed and treated for benign disease (n?=?22) and healthy women (n?=?60), were also assessed longitudinally. Results for 4 life areas are reported: (a) Emotional response to the life-threatening diagnosis and anticipation of treatment was characterized by depressed, anxious, and confused moods, whereas the response for women with benign disease was anxious only; these responses were transitory. (b) There was no evidence for a higher incidence of relationship dissolution or poorer marital adjustment; however, 30% of the women treated for disease reported that their partners may have had some sexual difficulty. (c) There was no evidence for impaired social adjustment. (d) Women treated for cancer retained their employment; however, their involvement was significantly reduced during recovery. Data suggest "islands" of significant life disruption following cancer, which do not appear to portend global adjustment vulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body image, physical attractiveness, and depression.

224 17–63 yr olds completed measures of self-perceived physical attractiveness and depression, and static full-body videotapes of Ss were assessed by objective raters, to investigate the relationship between Ss' body image, rated physical attractiveness, and depression. Measures included the Body-Self Relations Questionnaire, Center for Epidemiologic Studies Depression Scale (CES-D), a body parts satisfaction scale, and a self-labeling depression scale. Ss were classified as depressed (n?=?35) or nondepressed (n?=?42) on the basis of conjunctive criteria of self-labeling and extreme groups on the CES-D. It was hypothesized that (1) depressed Ss would report being less satisfied with their body parts and physical appearance and would regard themselves as less physically attractive than would nondepressed Ss, (2) objective raters would perceive depressed Ss as less physically attractive than nondepressed Ss, and (3) depressed Ss would distort their degree of physical attractiveness and perceive themselves to be less attractive than objective raters regarded them. Results indicate that, as hypothesized, depressed Ss were less satisfied with their bodies and saw themselves as less physically attractive than nondepressed Ss. These groups did not differ with respect to observer-rated physical attractiveness. Support was obtained for A. T. Beck's (1973, 1976) cognitive hypothesis that depressed persons negatively distort their body images; however, results also indicate substantial positive distortion among nondepressed Ss. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support, support groups, and the cancer patient.

Surveys the literature on social support and cancer and reports results from an empirical investigation of the factors that led cancer patients to join social support groups. Questionnaire data from 666 21–89 yr old cancer patients show that although most Ss received high levels of social support following cancer, some experienced isolated instances of rejection or did not receive the type of support they wanted from family, friends, and medical caregivers. This appeared to be 1 impetus for joining cancer support groups, although Ss reporting a lack of social support were not generally more likely to join support groups than were other Ss. The Profile of Mood States suggested that attenders were somewhat less likely to be depressed than were nonattenders. In addition, cancer support group attenders were more likely to be White middle-class females, to report having more problems, and to use social support resources of all kinds than were nonattenders. Implications for outreach to cancer patients are discussed, and it is concluded that while support groups may be beneficial for many cancer patients, current programs tend to be used largely by the same segment of the population that uses traditional mental health services. (81 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)