Moderators of the benefits of psychoeducational interventions for men with prostate cancer.

The authors examined whether 3 individual difference variables--self-esteem, self-efficacy, and depressive symptoms--interacted with psychoeducational group interventions for men with prostate cancer (n = 250) to predict general and prostate-specific quality of life. Men with nonmetastatic prostate cancer were randomly assigned to an education intervention, an education plus group discussion intervention, or usual care and followed for 12 months. Eight groups of 10 to 12 men were convened in each condition. Men who began the study with lower self-esteem, lower prostate-specific self-efficacy, and higher depressive symptoms benefited the most from the interventions. Of these 3 moderator variables, the most consistent results emerged for self-esteem. That is, the benefits of the intervention were strongest for men with low self-esteem.     

Millon Behavioral Medicine Diagnostic (MBMD) Predicts Health-Related Quality of Life (HrQoL) Over Time Among Men Treated for Localized Prostate Cancer

Prostate cancer treatment presents multiple challenges that can negatively affect health-related quality of life (HrQoL), and that can be further compromised by maladaptive personality styles and psychological adjustment difficulties. This study examined the utility of a comprehensive psychosocial screening tool to identify psychosocial traits that prospectively predict HrQoL status among men treated for localized prostate cancer. The Millon Behavioral Medicine Diagnostic (MBMD) was administered to 66 men (M age = 68 years, 59% White) treated by either radical prostatectomy or radiotherapy along with standard measures of general and prostate-cancer-specific quality of life assessed at a 12-month follow-up. Higher scores on both summary MBMD Management Guides (Adjustment Difficulties and Psych Referral) and higher scores on personality styles characterized by avoidance, dependency, depression, passive aggressiveness, and self-denigration predicted lower HrQoL (β range = –.21 to –.50). Additionally, higher scores on the MBMD Depression, Tension-Anxiety, and Future Pessimism scales predicted lower HrQoL. Finally, higher scores on the MBMD Intervention Fragility and Utilization Excess scale also consistently predicted poorer mental and physical health functioning over time. These results point to the utility of the MBMD to help screen for potential impairments in mental and physical health functioning in men undergoing treatment for prostate cancer.     

Perceptions of the roles of behaviour and genetics in disease risk: Are they associated with behaviour change attempts

Objective: We examined selected survivor characteristics to determine what factors might moderate the response to two psychosocial interventions.

Design: Seventy-one prostate cancer survivors (PCSs) were randomly assigned to either a telephone-delivered health education (THE) intervention or a telephone-delivered interpersonal counselling (TIP-C) intervention.

Measures: Psychological quality of life (QOL) outcomes included depression, negative and positive affect, and perceived stress.

Results: For three of the psychological outcomes (depression, negative affect and stress), there were distinct advantages from participating in THE. For example, more favourable depression outcomes occurred when men were older, had lower prostate specific functioning, were in active chemotherapy, had lower social support from friends and lower cancer knowledge. Participating in the TIP-C provided a more favourable outcome for positive affect when men had higher education, prostate specific functioning, social support from friends and cancer knowledge.

Conclusion: Unique survivor characteristics must be considered when recommending interventions that might improve psychological QOL in PCSs. Future research must examine who benefits most and from what components of psychosocial interventions to enable clinicians to recommend appropriate psychosocial care.     

Unrealistic optimism and genetic risk

The study examined whether life stress moderated the effects of a physical activity intervention. Women (n = 184) and 154 men (61% non-Hispanic white, average age 24 years) from an urban university participated. Data were analyzed separately for men and women using a 2 × 2 ANCOVA adjusting for baseline physical activity (intervention vs. control × high life stress vs. low stress) with total physical activity at one-year and two-year assessments as dependent variables. No significant main effect for stress or condition was found. The interaction was significant (p = 0.015) for men at one-year, indicating that men in the intervention group with high stress were more active than low stress intervention men. Instruction received in the intervention group on the stress-relieving properties of physical activity may have helped men with high stress to adopt or maintain physical activity.     

Men's Adjustment to Prostate Cancer: The Role of Agency and Unmitigated Agency

We examined how two male gender-related traits, agency (focus on self) and unmitigated agency (focus on self to the exclusion of others), were related to physical and emotional functioning in 162 men (92% Caucasian) treated for prostate cancer. As predicted, unmitigated agency was associated with worse functioning and more cancer-related difficulties. By contrast, agency was associated with better functioning and fewer cancer-related difficulties. We tested whether difficulties expressing emotions explained these relations. Unmitigated agency was associated with difficulty expressing emotions, and agency was associated with the ability to express emotions. Structural equation modeling was used to show that emotional expressiveness mediated the relations of unmitigated agency and agency to adjustment to prostate cancer. The implications of these results for interventions to enhance men's adjustment to prostate cancer are discussed.     

Psychological adjustment among African American breast cancer patients: one-year follow-up results of a randomized psychoeducational group intervention.

The effectiveness of support group interventions for cancer patients has been established among White patients but has been virtually unstudied among minority patients. The current study represents the 1st randomized support group intervention targeted to African American women with breast cancer. Participants (N = 73) with nonmetastatic breast cancer were randomly assigned to an 8-week group intervention or an assessment-only control condition At 12 months, the intervention resulted in improved mood as well as improved general and cancer-specific psychological functioning among women with greater baseline distress or lower income. Subsequent research is needed to address effective methods of enrolling and following women with fewer psychosocial and financial resources, as they were the most likely to benefit from this particular intervention.     

A randomized controlled trial of single versus multiple health behavior change: promoting physical activity and nutrition among adolescents.

Targeting multiple behaviors for change may provide significant health benefits. This study compared interventions targeting physical activity and nutrition (PAN) concurrently versus physical activity (PA) alone. Adolescents (N=138) were randomized to the PAN or PA intervention or control condition (n=46 per group). Primary outcomes were change in PA accelerometer and 3-day dietary recording from baseline to 3-month follow-up. The PAN and PA interventions were efficacious in supporting boys' (p<.001) but not girls' (p=.663) PA relative to the control condition. Dietary change was minimal. Although the findings do not reveal a decrement to PA promotion when a nutrition intervention was added, neither do they reveal any additional benefit. More studies comparing single versus multibehavioral interventions are needed.     

Examining Compulsive Sexual Behavior and Psychopathology Among a Sample of Postdeployment U.S. Male and Female Military Veterans

Compulsive sexual behavior (CSB) is defined as difficulties in controlling inappropriate or excessive sexual fantasies, urges, or behaviors that cause subjective distress or impairment in important areas of daily functioning. Using data from a baseline telephone interview, we examined the prevalence of CSB in a convenience sample of 820 postdeployed U.S. military male and female veterans and investigated correlates of CSB with sociodemographics and other mental health and sexual history characteristics. More men (13.8%) than women (4.3%) endorsed CSB-related symptoms. Given the limited sample size of women reporting CSB, correlational analyses were conducted only with men. After adjusting for significant sociodemographics, results indicated that gambling, suicidality, and sexually transmitted infections were significantly associated with male CSB. Current results suggest that CSB may be prevalent among U.S. military veterans post deployment and associated with significant negative health indices in men. CSB warrants attention regarding screening and intervention.     

The effects of a brief time perspective intervention for increasing physical activity among young adults

Past research has demonstrated that health behavior is correlated with time perspective: long-term thinkers are more likely than short-term thinkers to engage in health protective behaviors and less likely to engage in health damaging behaviors. To date, however, no research has experimentally demonstrated that time perspective is causally related to health behavior. We designed a brief (three 1/2-h weekly sessions) time perspective intervention to enhance long-term thinking about physical activity and examined its efficacy among two samples of young adults who signed up for fitness classes at a university recreational facility. Participants were assigned to one of three conditions: time perspective intervention, goal-setting control intervention, and no-treatment control. In Study 1, physical activity levels were assessed at preintervention, at postintervention (3 weeks later), and at 10-week follow-up (7 weeks after completion of the intervention). Controlling for preintervention physical activity levels, time perspective participants reported increased levels of physical activity relative to both other groups at postintervention, and relative to the no-treatment group at 10-week follow-up. This study provides the first experimental evidence that the effects of health behavior interventions may be enhanced by increasing participants’ long-term time perspective, and that time perspective is causally associated with health behavior. Study 2 replicated some of the effects of Study 1 using a larger sample, a six-month follow-up interval, and improved measurement of outcome. Together Studies 1 and 2 suggest that time perspective is an important ingredient in interventions designed to promote physical activity.     

Factors associated with the mental health of adolescents when a parent has cancer

This study explored factors associated with the mental health in adolescents (ages 11-17; n = 54) within 12 months after a parent had been diagnosed with cancer. A control group was included (ages 11-17; n = 49). A demographic questionnaire, the SF-8 Health Survey, the Youth Self Report and the McMaster Family Assessment Device were used. Similar levels of psychological distress and healthy family functioning were reported in the clinical and the control group. No effect of gender of the ill parent and that of the adolescent was found. A negative correlation was found between the physical health of the ill parent and the mental health of the adolescent. Healthy family functioning correlated with less psychological distress in adolescents with a parent with cancer. Open communication, flexible problem solving and appropriate affective involvement were significant predictors for less psychological distress in the adolescents. The study concludes that a healthy family functioning facilitated the adolescent's adjustment to parental cancer.     

Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial

The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n?=?47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d?=?0.68) than the control condition (d?=?0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r?=?0.62) and barriers self-efficacy (r?=?0.63) and decreases in depression (r?=?-0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling.     

The relationship between guardian certification requirements and guardian sanctioning: a research issue in elder law and policy

This study investigated the relationship between guardian certification requirements and guardian sanctioning in the state of Washington. A total of 377 files were examined. Findings show that 52.4% of guardians with an undergraduate degree or higher education are likely to be sanctioned compared with 42.2% with an Associate of Arts (AA) or Technical (Tech) degree, and 36.9% with a high school diploma (HS) or equivalency (GED). Guardians with an undergraduate or higher education are 1.88 times more likely to be sanctioned compared with GED or HS graduates (p < 0.05). However, 83.3% of GED or HS graduates are likely to have more severe sanctions compared with 76.4% undergraduate or higher education, and 47.7% with an AA or Tech degree, respectively. Guardians with an AA or Tech degree are 0.28 times less likely to have more severe sanctions than guardians with an undergraduate degree or higher education (p < 0.01). The results are discussed with respect to guardian registration, licensing, certification and quality; licensing and regulation of other professions; the limitations of the study; and the need for further research.     

Relationships among individualism--collectivism, gender, and ingroup/outgroup status, and responses to conflict: a study in China and the United States

Responses to conflict were studied in samples of college students from a highly collectivistic society (China, n = 207) and a highly individualistic society (United States n = 209). As predicted, the collectivistic society reported more conflict-reducing behaviors and less verbal or physical aggression. However, the effect of individualism/collectivism was moderated by both the ingroup/outgroup status of the target and gender of the participant. Chinese and US women did not differ on any measure. However, of the four groups, Chinese men reported the most conflict-reducing behaviors and the least physical aggression, whereas US men reported the fewest conflict-reducing behaviors and the greatest physical aggression. As predicted, conflict-reducing behaviors were more common in the ingroup condition and both verbal and physical aggression was more common in the outgroup condition. However, the latter were moderated by gender of the participant. US men reported greater physical aggression than any other group. Neither gender nor society had any effect on the level of indirect aggression. There were no gender or individualism/collectivism effects on indirect aggression. Observed gender effects were attributed to differences in how collectivistic and individualistic societies conceptualize masculinity. The effect sizes associated with the ingroup/outgroup condition were consistently and substantially larger than effect sizes associated with individualism/collectivism or gender.     

Social,Religious and Spiritual Capital and Physical/Emotional Functioning in a National Sample of African Americans

Spiritual and religious capital are forms of the broader construct of social capital. The present study, using probability‐based sampling methods, surveyed a national sample of African American adults to examine the relative contributions of spiritual and religious capital to their physical and emotional functioning. Analyses were conducted to determine if these constructs made a unique contribution above and beyond general social capital. African American men and women (N = 803) were interviewed by telephone. Hierarchical linear regressions revealed that, across the full sample, although social capital was a positive predictor of physical and emotional functioning (p < .05 and p < .001), neither religious nor spiritual capital made an additional contribution to these outcomes. However, the relationships among these variables differed for men and women. Among men, social capital predicted positive emotional functioning (p < .001) but not physical functioning; spiritual and religious capital made no additional contribution to either outcome variable. Among women, social capital predicted positive emotional functioning (p < .01) but not physical functioning. However, religious capital did make a significant additional contribution to the prediction of emotional functioning (ΔR², p < .01). Dividing the sample into different age groups did not produce any different findings from those found with the sample as a whole. Findings are discussed in terms of implications for church‐ and faith‐based health promotion interventions aimed at health disparities reduction. Copyright © 2011 John Wiley & Sons, Ltd.     

Who talks? The social psychology of illness support groups

More Americans try to change their health behaviors through self-help than through all other forms of professionally designed programs. Mutual support groups, involving little or no cost to participants, have a powerful effect on mental and physical health, yet little is known about patterns of support group participation in health care. What kinds of illness experiences prompt patients to seek each other's company? In an effort to observe social comparison processes with real-world relevance, support group participation was measured for 20 disease categories in 4 metropolitan areas (New York, Chicago, Los Angeles, and Dallas) and on 2 on-line forums. Support seeking was highest for diseases viewed as stigmatizing (e.g., AIDS, alcoholism, breast and prostate cancer) and was lowest for less embarrassing but equally devastating disorders, such as heart disease. The authors discuss implications for social comparison theory and its applications in health care.     

Contracting, prompting, and reinforcing substance use disorder continuing care: a randomized clinical trial.

Although continuing care is strongly related to positive treatment outcomes for substance use disorder (SUD), participation rates are low and few effective interventions are available. In a randomized clinical trial with 150 participants (97% men), 75 graduates of a residential Veterans Affairs Medical Center SUD program who received an aftercare contract, attendance prompts, and reinforcers (CPR) were compared to 75 graduates who received standard treatment (STX). Among CPR participants, 55% completed at least 3 months of aftercare, compared to 36% in STX. Similarly, CPR participants remained in treatment longer than those in STX (5.5 vs. 4.4 months). Additionally, CPR participants were more likely to be abstinent compared to STX (57% vs. 37%) after 1 year. The CPR intervention offers a practical means to improve adherence among individuals in SUD treatment.     

The relationship between instrumental and expressive traits,health behaviors,and perceived physical health

Relations between instrumental and expressive traits, health behaviors, and self-reported physical health were examined among young adults. Individuals (169 men, 167 women) completed two measures of instrumental and expressive traits, the Bem Sex Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ). Ethnic background of the sample included 72% European Americans, 13% Latin Americans, 6% Asian Americans, 5% African Americans, less than 1% Native American, and 4% did not specify a particular category. Expressive traits from the BSRI, and expressive and instrumental traits from the PAQ were associated with health behaviors, after controlling for neuroticism. Neuroticism explained 43% of the variance in perceived physical health. Separation of individuals into four groups on the basis of instrumental and expressive traits showed that androgynous individuals reported significantly better health practices than other individuals providing support for the androgyny model.     

Knowledge and perceived risk of major diseases in middle-aged and older women.

Women's (N = 200; 41-95 years) knowledge of mortality risks and their perceived general risk, personal risk, control, and preventability of coronary heart disease (CHD) and breast, colon, and lung cancer were examined. Middle-aged (MA) women were more accurate in their mortality knowledge for MA men than for MA women and were more accurate for MA than for older (OA) men and women. OA women, in contrast, were least accurate in their mortality knowledge for OA women compared with all other target groups; only 34% knew that CHD is the leading cause of death in OA women. Participants also overestimated a woman's risk of death from breast cancer and underestimated the risk from lung and colon cancer. Ratings of perceived risk, control, and preventability varied as a function of disease. OA women in particular appear to lack knowledge regarding women's risk of major diseases. Results have implications for women's health behaviors and medical decisions.     

三维干预促进小学生心理健康的研究

为了探索有效的小学生心理健康教育模式,以昆明市两所普通小学分别作为实验组和对照组进行了为期两年的实验研究,对影响小学生心理健康的主要因素:教师、家长和学生自身三个子系统进行了多侧面的三维干预。结果表明:(1)实验组学生比对照组学生的总体一般焦虑水平下降;(2)学习适应性提高;(3)问题行为症候群的学生人数和问题行为比干预前明显减少。验证了教师、家长、学生三维干预结合模式对促进小学生心理健康的有效性。     

Emotional plasticity: conditions and effects of improving emotional competence in adulthood

This study aimed to investigate (a) whether it is possible to increase emotional competence (EC) in adulthood; (b) whether this improvement results in better mental, physical, and social adjustment; (c) whether this improvement can be maintained 1 year later; and (d) whether these benefits are accompanied by a reduction in stress-hormone secretion (i.e., cortisol). One hundred and thirty-two participants were randomly assigned to an EC-enhancing intervention (in group format) or to a control group. Participants in the intervention group underwent a specifically designed 15-hr intervention targeting the 5 core emotional competencies, complemented with a 4-week e-mail follow-up. Results reveal that the level of emotional competencies increased significantly in the intervention group in contrast with the control group. This increase resulted in lower cortisol secretion, enhanced subjective and physical well-being, as well as improved quality of social and marital relationships in the intervention group. No significant change occurred in the control group. Peer reports on EC and quality of relationships confirmed these results. These data suggest that emotional competencies can be improved, with effective benefits on personal and interpersonal functioning lasting for at least 1 year. The theoretical implications of these results as well as their practical implications for the construction and the development of effective emotional competencies interventions are discussed.