Evaluation of a psychosocial intervention on social support, perceived control, coping strategies, emotional distress, and quality of life of breast cancer patients

The purpose of this research was to demonstrate that a specific psychosocial intervention changes reactions to cancer and quality of life. This study was carried out on 66 patients with a first breast cancer. Patients were randomly divided into two groups: a specific intervention group (G1, 8 sessions) or a support group (G2, 8 sessions). A control group (G3) was composed of patients who refused to participate in psychological intervention. Social support, perceived control, repression of emotions, coping strategies, emotional distress, and quality of life were assessed one week before (T1) and at the end (T2) of the psychological intervention. Results showed that G1 did not have significantly modified quality of life or psychological scores. Patients of G2 had poorer emotional quality of life, use of internal causal attributions, and minimized their illness at T1 as compared to patients of G3. At Time 2 these differences were not observed.     

Youth suicide risk and sexual orientation

Using a broad suicide risk assessment (suicidal ideation, hopelessness, hostility) with 100 youth ages 17 to 19, this study examined the relationship between sexual orientation and youth suicide risk. Participants were compared across sexual orientation, as well as level of perceived external support, which may be a mitigating variable in suicide risk. The suicide risk demonstrated by sexual minorities in this study was no greater than that of their heterosexual peers. Youth who reported more external support demonstrated lower overall suicide risk and, specifically, lower levels of hostility, hopelessness, and suicidal ideation. The results indicated that suicide risk is not determined by demographic criteria alone, and may be influenced by psychosocial variables, such as support.     

Social support,social integration,and health-related quality of life over time: Results from the Fitness and Arthritis in Seniors Trial (FAST)

The present study tested whether baseline perceived social support and social integration predicted baseline and follow-up measures of health-related quality of life for 364 older adults with osteoarthritis. The findings are secondary analyses of a randomized controlled trial of an exercise intervention. Multiple regression analyses indicate that perceived social support was related to baseline measures of functioning in psychological (depressive symptoms, social functioning, and life satisfaction) and physical domains (self-rated disability, observed physical function, and perceived health), after accounting for demographic and clinical status factors. At 18-month follow-up (additionally controlling for exercise intervention and baseline outcomes), social support significantly predicted changes in psychosocial functioning, but was unrelated to changes in self-reported and observed physical health. The findings indicate that social support is an important predictor of long-term psychosocial outcomes, but is less important than baseline clinical status for physical health endpoints in this cohort of older adults. In contrast, social integration was not a consistent predictor of outcomes.     

Effects of perceived social support and family demands on college students' mental well‐being: A cross‐cultural investigation

The effects of perceived social support and family demands on college students' mental well‐being (perceived stress and depression) were assessed in 2 samples of Jordanian and Turkish college students. Statistically significant negative correlations were found between perceived support and mental well‐being. Multiple regression analyses showed that perceived family support was a better predictor of mental well‐being for Jordanian students, while perceived support from friends was a better predictor of mental well‐being for Turkish students. Perceived family demands were stronger predictors of mental well‐being for participants from both ethnic groups. Jordanian and Turkish participants who perceived their families to be too demanding were more likely to report higher depression and stress levels. None of the interactions between social support or family demands and either of the 2 demographic variables were statistically significant. These findings provide a more nuanced view of the relationship between social support and mental health among college students, and point to the relevance of some cultural and situational factors. They also draw further attention to the detrimental effects of unrealistic family demands and pressures on the mental health of college youths.     

Evaluation of an integrated fluency and Acceptance and Commitment Therapy intervention for adolescents and adults who stutter: Participant perspectives

PurposeChildhood-onset stuttering is a neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter. In addition to significant challenges in personal, social, and emotional domains, stuttering has been shown to impose an economic burden on adults who stutter. Intervention for adults who stutter has historically addressed speech fluency more so than the covert psychosocial aspects of the disorder. There is an identified clinical need for holistic, efficacious, and cost-effective stuttering interventions that meet consumer needs. The purpose of the present study is to evaluate a novel, integrated intervention that combined traditional fluency techniques with Acceptance and Commitment Therapy, from the perspective of the adults who stutter who participated in the intervention.MethodTwenty-eight adults who stutter completed the intervention program. Participants were invited to complete an online post-program written survey (including qualitative comments) and a semi-structured interview to explore their evaluations of the program with respect to its authenticity, acceptability, and social validity.ResultsParticipants perceived positive psychosocial changes as a result of the program, and were satisfied with the program overall. Qualitative thematic analyses of the written survey comments and the semi-structured interviews identified two major themes: factors specific to the intervention and factors specific to the therapeutic process. Several important sub-themes were also identified.ConclusionFindings support the authenticity, acceptability, and social validity of an integrated fluency and psychosocial intervention for stuttering. Findings also highlight the need for consideration of the consumer voice in the management of stuttering disorders, in keeping with person-centred care.     

Psychological characteristics of people with Parkinson's disease who prematurely drop out of professionally led Internet chat support groups.

Researchers of Internet health interventions have begun to address the problems of high attrition rates. Attrition has been a problem for psychosocial interventions for nearly 50 years. It is ubiquitous no matter what the type of intervention or the modality of delivery. Consistent are the repeated findings that demographic characteristics are the most robust variables. We tested the hypothesis that the greater the fear and apprehension experienced in professionally led Internet support groups, the more likely the participants would not complete the 25-week intervention. The sample consisted of 66 people with Parkinson's disease; each participant was assigned to one of six chat groups. To assess psychological states, we used PCAD, a text analysis program analyzing each person's postings during each chat room session. There was a statistically significant difference between those who terminated the group early and those who completed the intervention on the Anxiety-Fear dimension, F=2.35, (6,63), p=0.03. People who dropped out demonstrated higher death and shame anxiety. A number of possible designs for online groups that may reduce premature attrition are discussed.     

Suicide prevention for high-risk persons who refuse treatment.

A program was developed to exert a suicide prevention influence on high-risk persons who decline to enter the health care system. There were 3,006 patients admitted to a psychiatric in-patient service because of a depressive or suicidal state who were contacted to determine if the post-discharge plan was followed. Half of those who refused their treatment program were contacted by telephone or letter on a set schedule. The contact was limited to expressing interest in the person's well-being. Mortality in the contact group was compared with the no-contact subjects and with the subjects who had accepted treatment, after 1, 2, 3, and 4 years. Suicidal deaths were found to diverge progressively in the three groups, the treatment subjects showing the highest rates, the no-contact group coming next, and the contact subjects showing the lowest. The observed divergence between the contact and no-contact groups provides tentative evidence that a high-risk population for suicide can be identified and that a system-atic approach to reducing that risk can be applied.     

Effects of Perceived Attitudinal and Demographic Similarity on Protégés' Support and Satisfaction Gained From Their Mentoring Relationships

The purpose of this study was to examine how perceived attitudinal similarity (measured as similarity in general outlook, values, and problem-solving approach) and demographic similarity operationalized as similarity in race and gender, affected protégés' support and satisfaction from their informal mentoring relationships. Scandura and Katerberg's (1988) 3-factor scale of mentor functions was used to measure vocational, psychosocial, and role-modeling support. Participants were 144 protégés from diverse backgrounds (54% female; 54% non-White). Perceived attitudinal similarity was a better predictor of protégés' satisfaction with and support received from their mentors than was demographic similarity.     

Targeted Audiences in Anti-Drug Ads: Message Cues,Perceived Exposure,Perceived Effects,and Support for Funding

Perceived exposure has been offered as the main factor in how people estimate the effects of media messages on others, but a recent study found this did not hold for two prosocial messages. This study (N = 160) shows that demographic cues in anti-drug messages may communicate who the intended targets are, thus influencing perceived exposure and perceived effects for different age, gender, and racial groups. In turn, perceived effects on the self and others predict support for funding anti-drug campaigns. The possible impact of perceived similarity between a group and the “implied audience” on perceived effects is discussed.     

Effects of Psychosocial Resources on Elite Soldiers' Completion of a Demanding Military Selection Program

The purpose of this study was to determine the effects of three psychosocial resources (social support, mattering, and self-efficacy), together and separately, on soldiers' completion of a physically challenging military program when controlling for the possible mediating effects of stress. A total of 380 male soldiers entering Special Forces Assessment and Selection Course served as subjects. Results showed that the psychosocial resources were significantly and positively related to the program completion. Expected stress and cognitive stress did not mediate this effect. Of the three psychosocial resources, only the effect of self-efficacy was statistically significant. Implications of the findings are discussed.     

The Nature and Correlates of Psychological Adjustment in Gay Men with AIDS-Related Conditions1

This study assessed differences in the psychological adjustment of gay men who tested positive for the antibody to the human immunodeficiency virus (HIV). Twenty-one were symptomatic for AIDS, and 27 were asymptomatic. A group of 15 gay men who tested negative for the HIV was included as a comparison group. Men in the three groups were equivalent on demographic variables. Symptomatic men reported more health problems than either asymptomatic or seronegative men. Relative to men who were symptomatic, those who were asymptomatic reported more death anxiety, less optimism, and greater severity of psychological distress, and reported more frequent use of avoidance and distancing as coping strategies. The poor psychological functioning of asymptomatic subjects was attributed to the uncertainty regarding their future health status. Generally, positive psychological well-being of symptomatic and asymptomatic men was related to the infrequent use of avoidance coping strategies and high satisfaction with perceived social support.     

A longitudinal study of psychosocial distress in breast cancer: prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Adolescent temperament,perceived social support,and depressive tendencies as predictors of depressive tendencies in young adulthood

A 5 year longitudinal study investigated the interrelations of temperament dimensions (negative emotionality, activity, and sociability), perceived social support (friend, significant other, and family support), and depressive tendencies. Temperament (EASTS; Buss, 1991), perceived social support (PSS‐R; Blumenthal, Burg, Barefoot, Williams, Haney and Zimet, 1987) and depressive tendencies (a modified version of the BDI) were measured by self‐reports in a randomly selected, community‐based sample of 302 adolescents at age 15, and depressive tendencies were measured again five years later at age 20. The authors hypothesized a model comprising direct as well as mediated effects between the adolescent predictor variables and depressive tendencies in young adulthood. The structural modelling analyses supported these hypotheses in part, and also indicated some qualitative sex differences. For both girls and boys, a significant direct as well as mediating role was indicated for the current level of depressive tendencies: depressive tendencies at age 15 predicted depressive tendencies at age 20, also mediating the effects of negative emotionality at age 15, and additionally mediating the effects of a low level of activity in girls and a low level of family support in boys. Furthermore, even when the prior level of depressive tendencies was controlled, direct effects were indicated in boys for a low level of sociability, and in girls for significant other support, which also mediated the effects of a low level of sociability. These results highlight the importance of the sex‐differentiated interplay of both intrapersonal and psychosocial factors in relation to depressive tendencies both during adolescence and from adolescence to young adulthood. Copyright © 1999 John Wiley & Sons, Ltd.     

Perceived racism and vascular reactivity in black college women: moderating effects of seeking social support.

This quasi-experimental study explored the association of perceived racism and seeking social support to vascular reactivity in a college sample of 110 Black women. Perceived racism and seeking social support were assessed via self-report, and vascular reactivity was measured before and during a standardized speaking task. Hierarchical regression analyses indicated that perceived racism was positively related to changes in systolic blood pressure. These analyses also indicated that seeking social support moderated the relationship between perceived racism and systolic blood pressure changes. This interaction effect persisted after controlling for several potential confounders. Follow-up regression analyses showed that perceived racism was positively associated with reactivity among participants who were low in seeking social support. A significant relationship was not observed between perceived racism and systolic blood pressure changes among participants who were high in seeking social support. Perceived racism and seeking social support were not significantly associated with changes in diastolic blood pressure. These findings highlight the importance of examining psychosocial factors that may mitigate the hypothesized relationship between perceived racism and reactivity.     

Establishing family foundations: intervention effects on coparenting, parent/infant well-being, and parent-child relations.

This study investigated the ability of a theoretically driven, psychosocial prevention program implemented through childbirth education programs to enhance the coparental relationship, parental mental health, the parent-child relationship, and infant emotional and physiological regulation. A sample of 169 heterosexual, adult couples who were expecting their 1st child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of 8 classes, delivered before and after birth, that was designed as a universal prevention program (i.e., it was applicable to all couples, not just those at high risk). Intent-to-treat analyses indicated significant program effects on coparental support, maternal depression and anxiety, distress in the parent-child relationship, and several indicators of infant regulation. Intervention effects were not moderated by income, but greater positive impact of the program was found for lower educated parents and for families with a father who reported higher levels of insecure attachment in close relationships. These findings support the view that coparenting is a potentially malleable intervention target that may influence family relationships as well as parent and child well-being.     

A longitudinal study of the psychosocial impact of stroke on primary support persons

We investigated longitudinally the effects of a stroke on the social support systems and well-being of the patient's primary support person, both acutely and as the condition stabilized. Individuals who had suffered a first stroke and a primary support person participated in two waves of data collection, carried out in 6-month intervals beginning 7 weeks after the stroke. Our data show that the prevalence of depressive symptoms is from 2 1/2 to 3 1/2 times higher than rates found among representative samples of middle-aged and elderly populations. Mean level of depression did not change over time, although level of optimism declined significantly. Multiple regression analyses showed that levels of depression and perceived burden in support persons are highly related to aspects of the stroke such as its severity, and that demographic variables such as age and income play a relatively minor role in attenuating these relations in the acute adjustment phase. However, from 7 to 9 months after the stroke, well-established demographic variables such as health, income, and age were significant predictors of depression. Individuals who were older and who had good health and higher incomes were least depressed.     

Cognitive and Social Factors Associated with NSSI and Suicide Attempts in Psychiatrically Hospitalized Adolescents

Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1 % female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n?=?45), SA only (n?=?24) or both NSSI and SA (NSSI+SA; n?=?79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed.     

An investigation of psychosocial factors related to changes in physical activity and fitness among female adolescents

Research examined the effects of a supervised physical activity program on potential psychosocial mediators and determined whether changes in these psychosocial variables predicted changes in physical activity and fitness. Sedentary adolescent females were assigned to an intervention (n?=?79) or comparison (n?=?67) group. Cardiovascular fitness (cycle ergometer), physical activity (3-Day Physical Activity Recall), and psychosocial variables related to physical activity (i.e., self-efficacy, perceived barriers, social support, enjoyment) were assessed at three time points over the 9-month study. An intention-to-treat analysis showed that the intervention did not impact any of the psychosocial variables, with the exception of perceived barriers, which increased in the intervention group. Longitudinal analyses showed that improvements in fitness were associated with positive changes in global self-efficacy and exercise enjoyment. Psychosocial variables did not mediate the program's effects on fitness or activity. However, individual level changes in psychosocial variables were related to changes in cardiovascular fitness.