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.     

Efficacy of a brief group psychoeducational intervention for bulimia nervosa

This study compared a brief group treatment that was designed to be purely educational (ED) with a longer course of individual cognitive-behavioural (CB) therapy intended to represent more standard clinical care. Participants were 65 women who sought treatment at Toronto General Hospital, met DSM-III criteria for bulimia nervosa at a normal weight and reported vomiting at least twice weekly. Results indicated that the CB treatment, as expected, was generally more effective than the ED intervention, but on several important outcome indices both treatments appeared to be equally effective for the healthiest 25-45% of the sample. The more intensive individual CB treatment was associated with greater improvement in patients who were more severely symptomatic. However, the ED intervention proved significantly more cost-effective and it was suggested that a sequential treatment program might achieve the superior benefits associated with the longer individual CB treatment at a reduced cost.     

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.     

Psychological adjustment among adult children of alcoholics: a cross-cultural study.

In this study, we compared Hispanic and Caucasian college students identified as adult children of alcoholics in terms of psychological adjustment using the Diagnostic Inventory of Personality and Symptoms (DIPS; Vincent, 1985). Results of the study suggested that, among college students, Caucasian men seem to be at a greater risk for using alcohol and drugs than Caucasian women or Hispanic men and women.     

Religiosity and Coping: Racial Stigma and Psychological Well-Being among African American Girls

Journal of Religion and Health - This study examined how having a relationship with God served as a protective factor between racial stigma beliefs and psychological well-being. A church sample of...     

The stage-specific role of spirituality among African American Christian women throughout the breast cancer experience

This study presents the results of semistructured interviews conducted with 18 African American Christian women regarding the role of spirituality throughout their breast cancer experiences. The spiritual themes relevant for phases of the breast cancer experience are identified. Analysis resulted in the identification of 11 codes and 5 subcodes that corresponded to the diagnosis, treatment, and posttreatment phases of the breast cancer experience. Most of the survivors indicated that their spirituality and faith assisted them throughout the breast cancer experience. Discussion focuses on the spiritual resources used by the participants at the different stages in the breast cancer experience. Attention is given to implications for how professionals can use these resources to assist African American women coping with breast cancer.     

Psychological intervention with couples coping with breast cancer: A systematic review

Objective: Information about psychological intervention with couples coping with breast cancer is not well-disseminated. This can be explained, at least in part, by the absence of knowledge about the efficacy of this kind of intervention. The aim of the present systematic review is to identify and describe psychological interventions for couples coping with breast cancer and evaluate their efficacy.

Design: Studies identified by a searching multiple literature databases related to health and psychology between 1975 and 2013. Rigorous inclusion and exclusion criteria were utilised.

Results: Of 129 abstracts, 13 were extracted for further analysis and a final ten studies were deemed eligible for inclusion. Data were extracted from each study regarding study sample characteristics, design, results and methodological limitations. The results obtained were mixed in regard to efficacy, although the overwhelming majority of studies (eight studies) found benefits for both women and their partners in some dimensions, such as quality of life, psychological distress, relationship functioning and physical symptoms associated with cancer.

Conclusion: Psychological interventions for couples coping with breast cancer appear to be effective for both women and their partners. However, further studies are needed to evaluate the efficacy of couple-based interventions and, to identify for whom and how they are more effective.     

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.     

Two forms of group therapy and individual treatment of work-related depression: a one-year follow-up study

Patients on long-term sick-leave (> 90 days) from white collar work, with a diagnosis of work-related depression, dysthymia, or maladaptive stress reaction were randomized either to cognitive group therapy (CGT), focused psychodynamic group therapy (FGT), or to a comparison group. All patients were interviewed and responded to self-report questionnaires before the start of treatment and at 6 and 12 months. At the 12-month follow-up, 70% of the patients met the criteria for reliable change of the target symptom (depression), and the sample as a whole improved significantly on all measures used. However, there were no differences in outcome between the three treatment groups.     

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.     

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

OBJECTIVE: The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. DESIGN: Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. MAIN OUTCOME MEASURES: The primary outcome measures for this study were psychological distress and psychological well-being. RESULTS: Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. CONCLUSION: The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.     

Incorporating family therapy into asthma group intervention: a randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs.     

Motivational enhancement therapy for African American substance users: a randomized clinical trial

Limited empirical evidence concerning the efficacy of substance abuse treatments among African Americans reduces opportunities to evaluate and improve program efficacy. The current study, conducted as a secondary analysis of a randomized clinical trial conducted by the Clinical Trials Network of the National Institute of Drug Abuse, addressed this knowledge gap by examining the efficacy of motivational enhancement therapy (MET) compared with counseling as usual (CAU) among 194 African American adults seeking outpatient substance abuse treatment at 5 participating sites. The findings revealed higher retention rates among women in MET than in CAU during the initial 12 weeks of the 16-week study. Men in MET and CAU did not differ in retention. However, MET participants self-reported more drug-using days per week than participants in CAU. Implications for future substance abuse treatment research with African Americans are discussed.     

Association of Poor Kin Relations,College Adjustment and Psychological Well-Being among African American Undergraduates

The purpose of this study was twofold. The first was to examine the association of poor kin relations with students’ psychological distress and college adjustment in a sample of 83 African American undergraduates. The second was to assess whether the relationship of poor kin relations with both psychological distress and college adjustment was mediated by perceived stress and self-esteem. Fifty-nine female and 24 male African American undergraduates were administered the study measures via online survey. Findings revealed that poor kin relations were positively associated with psychological distress and negatively related to college adjustment. Evidence of the meditational role of perceived stress and self-esteem was found. Poor relations with kin were linked to increased vulnerability to stress and decreased self-esteem, which in turn, was associated with increase in psychological distress and decrease in college adjustment. For counselors, administrators and faculty concerned with the adjustment and retention of ethnic minority undergraduates, understanding the role of extended family and other off-campus relations in students’ psychological well-being may be highly important.     

The specificity of maternal parenting behavior and child adjustment difficulties: a study of inner-city African American families.

The specificity of the association between 2 parenting behaviors (warmth and supervision) and 2 indicators, aggressive behavior and depressive symptoms, of major child outcomes (externalizing problems and internalizing problems) was examined among 196 inner-city African American mothers and their school age children. Given the growing number of African American families affected by HIV/AIDS and demonstrated compromises in parenting associated with maternal infection, the moderating role of maternal HIV/AIDS was also examined. Findings from longitudinal analyses supported the specificity of maternal warmth but not of maternal supervision. Maternal warmth was a stronger predictor of decreases in child aggressive behavior than of decreases in depressive symptoms. In addition, maternal warmth was a stronger predictor of decreases in aggressive behavior than was maternal supervision. Parenting specificity was not moderated by maternal HIV/AIDS. Clinical implications and future research directions are discussed.     

Perceived social support mediates between prior attachment and subsequent adjustment: a study of urban African American children.

The processes whereby attachment and other social and cognitive factors contribute to social and emotional adjustment were examined. Participants were 56 African American children from low-income urban families. Attachment and sociability were assessed in the strange situation when children were 4.5 years old. Two years later, children were interviewed regarding their perceptions of social support and their attributions about others' intentions. Also assessed at Time 2 were child verbal intelligence, defensive response style, children's self-reports, and parent reports of child adjustment. As expected, attachment uniquely predicted perceived social support. Insecure attachment predicted self-reports of behavior problems and parental report of internalizing problems. Perceived social support was associated positively and significantly with viewing ambiguously depicted actions as prosocial rather than aggressive. Perceived social support was found to mediate the relation between attachment and adjustment. Results suggest that behaviorally mediated strategies for relating to caregivers in early childhood predict generalized social perception, thought, and emotion at later ages.     

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.