Posttraumatic Stress Among Women With Breast Cancer and Their Daughters: Relationship With Daughters' Breast Cancer Screening

Cancer-related posttraumatic stress (PTS) in women with breast cancer, perceived risk of cancer in these women's daughters, and daughters' PTS related to their mothers' breast cancer were tested for relationships to daughters' breast self-examination (BSE) and mammography activity. Daughters' mammography frequency was related to her own PTS, but not to her perceived risk or her mothers' PTS. In contrast, daughters who overperformed BSE had mothers reporting significantly greater PTS than those performing BSE at recommended rates or underperforming BSE. Daughters' BSE and mammography frequency were not correlated. Differing demands related to BSE and mammography, and their relationship to different distress variables are discussed.     

Social Comparisons and Adjustment Among Cardiac Patients1

The research examined social comparisons, affiliative choices, and their relation to adjustment among patients in a cardiac rehabilitation program. Consistent with Taylor and Lobel (1989), evaluative and affiliative processes diverged, with patients making downward evaluations (Wills, 1981) but choosing to affiliate with those who were better off than themselves. Consistent with predictions, downward evaluation was associated with better psychological adjustment, supporting the idea that these comparisons meet self-enhancement needs; upward affiliations were associated with hopefulness and inspiration, as well as with the perception that such comparisons provide information that is useful for improving one's own condition. The implications of evaluative comparison and affiliative activities for coping is discussed.     

Measurement of Depressive Symptoms in Women With Breast Cancer and Women With Clinical Depression: A Differential Item Functioning Analysis

Differential item functioning (DIF) analyses of the Beck Depression Inventory-II (BDI-II) were conducted on samples of 267 women with breast cancer and 294 women with clinical depression. Patterns of items in which there was significant and nonsignificant DIF were identified using statistical tests and measures of DIF effect size. At the most general level, 15 of 21 BDI-II items were associated with nontrivial DIF suggesting that the item responses of these samples do not reflect the same underlying construct. Factor analyses of the BDI-II using a psychometrically defensible method for item level factor analysis supported the conclusions from the DIF analyses. These findings suggest that researchers and practitioners should apply caution when interpreting self-report depression symptoms in breast cancer patients.     

Risk Perception Among Women at Risk for Hereditary Breast and Ovarian Cancer

This paper is a summation of selected history and literature on risk perception as it pertains to genetic counseling and testing, with a focus on hereditary breast and ovarian cancer, the area which has seen the greatest focus of research. Risk perception is a complex and incompletely understood concept which seeks to capture the myriad meanings that an individual attaches to the experience of being at increased risk. It is now evident that “risk”, as perceived by the patient, is different from the objective, quantifiable risk estimate often provided to them during genetic counseling. What is also clear is that the complicated set of factors influencing risk perception are not yet well understood, nor are the mechanisms the lead from perceived risk to behavioral change in the patient. In situations where specific behavioral changes such as increased cancer screening are an inherent goal of the genetic risk assessment and counseling process, gaining a better understanding of the specific factors motivating change will be essential.     

Distress and Internalized Homophobia Among Lesbian Women Treated for Early Stage Breast Cancer

A convenience sample of 57 lesbian women who had been recruited for a study of adjustment to breast cancer completed measures of internalized homophobia, degree of disclosure of sexual orientation, social support, self-esteem, and distress. Consistent with our prediction, internalized homophobia related to greater distress. Contrary to our prediction, disclosure did not relate to lower distress. Path models were consistent with the position that internalized homophobia promotes distress through lower self-esteem and perceived unavailability of social support. However, the data were also consistent with a model in which low self-esteem leads to internalized homophobia by way of elevated distress. Internalized homophobia also related inversely to utilization of health care resources. Our discussion centers on the need for more information regarding this understudied population.     

Social Comparison Among Individuals With Rheumatoid Arthritis1

This study examined the types of social comparisons made by individuals with rheumatoid arthritis (RA) and the role these comparisons play in illness adjustment. Seventy-five women with RA were interviewed. The interview included measures of social comparison preferences assessed within two different contexts: the establishment of standards for desired performance and the experience of performance difficulties. Perceived ability, satisfaction with ability, and psychological adjustment also were assessed. We found that when respondents were experiencing performance difficulties they compared more frequently with other RA patients than with individuals not affected by RA. However, when establishing standards for desired performance, the latter type of comparison was more common. Further, respondents' comparison preferences were not related to perceptions of ability, but were related to satisfaction with ability. Greater satisfaction was associated with comparison with individuals not affected by RA when establishing standards for desired performance and comparison with other RA patients when experiencing performance difficulties. Satisfaction, in turn, was positively related to psychological adjustment.     

Social Comparisons and Absenteeism: A Structural Modeling Approach1

In this study a social comparison model is constructed that predicts objectively recorded absence frequency among male Dutch blue-collar workers from a metal factory in the Netherlands. By employing LISREL, the model is developed (tested and revised) in Plant North (N = 254), and successfully cross-validated in Plant South (N= 199). The study demonstrates the impact of two social comparison processes upon absenteeism. Absenteeism is the result of: (a) the perception that one is less well-off than one's colleagues on several job aspects, and (b) the adjustment of one's personal absence norm to that of the work group. In addition, our study reveals that, rather than being absent or having tolerant absence norms, employees may develop feelings of resentment in response to perceived inequity and a tolerant group absence norm. It is concluded that social comparison theory enhances our understanding of absenteeism.     

Affect Generated by Social Comparisons Among Nurses High and Low in Burnout1

The affective consequences of social comparison were examined in 2 field studies among nurses and related to the 3 dimensions of professional burnout: emotional exhaustion, reduced personal accomplishment, and depersonalization. Study t was conducted in a sample of 99 nurses of a psychiatric hospital, and Study 2 in a sample of 237 nurses employed in various settings In general, upward comparisons evoked more positive and less negative affect than did downward comparisons. However, the affective consequences of social comparison were different for those high and low in burnout. Those low in personal accomplishment reported higher levels of negative affect from upward comparisons and higher levels of positive affect from downward comparisons than did those high in personal accomplishment. In addition, in Study 2, those high in depersonalization and emotional exhaustion derived more positive affect from downward comparisons than did those with lower levels of burnout.     

Mentoring Among Women Lawyers1

Considerable controversy exists as to both the nature and efficacy of mentoring among women professionals. As noted by Wrightsman, this controversy persists largely because researchers have failed to use a common scientific definition of the concept. In the present research a survey of existing studies was used to set a more stringent criterion of mentoring than that usually employed. Data were then gathered from a sample of women lawyers in the State of Oregon. Results indicated that those meeting the more stringent criterion perceived themselves as more successful and satisfied in their careers than those not meeting it. Those women who said that they had mentors but who did not meet the criterion reported themselves as less successful and satisfied than those who claimed to have a mentor and met the criterion. These results are seen as demonstrating the value of the more stringent criterion as well as the possible value of true mentors to women professionals.     

Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.     

Psycho-Spiritual Integrative Therapy for Women with Primary Breast Cancer

Breast cancer presents physical and psychological challenges, but can also result in posttraumatic growth (PTG). Twenty-four women completed Psycho-Spiritual Integrative Therapy (PSIT) treatment and completed assessments for PTG and QOL before, immediately following, and 1 month after treatment. Women showed improvement (p?相似文献   

Physical Attractiveness and Psychological Adjustment Among Substance Abuse Inpatients: A Longitudinal Study1

Relations between psychological adjustment and physical attractiveness were examined longitudinally in substance abuse inpatients, controlling for the effects of length of drug abuse, length of inpatient stay, age, and socioeconomic status. Measures of adjustment and attractiveness were obtained during the first week of admission and six weeks later (within two weeks of discharge). Regression analyses indicated that initial attractiveness did not predict later adjustment, and initial adjustment did not predict later attractiveness. Partial correlation analyses revealed a positive association between attractiveness and adjustment at the first time point, but not at the later time point. These results suggest that physical attractiveness exerts only a temporary effect on judgments of adjustment in an inpatient setting. Attractiveness may affect decisions made when screening patients at mental health facilities, but may not affect decisions made over the full course of inpatient treatment.     

Psychosocial Barriers to Cervical Cancer Screening: Concerns With Self-presentation and Social Evaluation1

The incidence of cervical cancer has decreased over 70% in the last several decades due in large part to the Papanicolaou (Pap) test. Despite the acknowledged efficacy of this test, however, many women do not receive cervical screening. The present study investigated the contributions of individual differences in concerns with self-presentation and social evaluation to the prediction of intentions and behavior involving cervical screening. Eighty-two Caucasian women completed measures of social anxiety, physique anxiety, public and private self-consciousness, fear of negative evaluation, and self-esteem, in addition to questions assessing their knowledge and behavior regarding cervical screening. Social anxiety significantly predicted intention to receive cervical screening for a medical reason, as well as the frequency with which the women actually received gynecological examinations. Physique anxiety accounted for a significant percentage of the variance in women's likelihood of receiving cervical screening within the next year. Interpersonal aspects of the gynecological exam, as well as implications of the findings for gynecological practice are discussed.     

Treatment of Body Image Dissatisfaction Among Women With Bulimia Nervosa

Body image dissatisfaction contributes to the development and maintenance of bulimia nervosa. Many women with bulimia are unhappy with their body's appearance and yearn to attain the thin shape glamorized by our culture. This obsession breeds low self-esteem, feelings of inadequacy, and resistance to recovery from bulimia. This article offers treatment suggestions for body image dissatisfaction as it relates to bulimia. Counselors must be comfortable with their own bodies and must be cognizant of sociocultural dictates demanding a thin body for women.     

Posttraumatic Stress in Women with Breast Cancer and Their Daughters

Using the PTSD Reaction Index, posttraumatic stress was assessed in 133 women with breast cancer and 64 of their daughters. Twenty-one percent of patients and 13% of daughters reported symptoms consistent with PTSD. PTSD in these patients without bone marrow transplants may be higher than reported in other samples, and the prevalence of PTSD symptoms in the daughters appear comparable to women with breast cancer. For patients, cancer stage at diagnosis was positively associated with posttraumatic stress severity. Mothers experiencing PTSD symptoms were significantly more likely to have daughters experiencing PTSD symptoms. Intergenerational patterns in reaction to breast cancer are discussed.     

A Structural Model for Adjustment to Aging among Older Women in Breast Cancer Remission

This study aims to build a structural model to explore the predictors of adjustment to aging (AtA) reported by older women in breast cancer remission. A community-dwelling sample of 771 older women in breast cancer remission aged between 75 and 98 years answered a questionnaire to determine socio-demographic (age, income, marital status, education, household, and living setting), and health-related characteristics (self-reported functional limitations and disabilities, time since remission, other type of cancer, breast reconstruction, perceived health, recent disease and medication). Several measures were employed to assess AtA, sense of coherence and subjective well-being. Structural equation modeling was used to explore a structural model of the self-reported AtA, encompassing all variables. Significant predictors of AtA are self-reported disability (β = .404; p < .001), time since remission (β = .371; p < .001), perceived health (β = .257; p < .001), other type of cancer (β = .231; p < .001), breast reconstruction (β = .153; p = .008), marital status (β = .141; p < .001), sense of coherence (β = .140; p < .001), and living setting (β = .139; p = .006). These variables accounted for 84.3% of the variability of AtA. Self-reported disability and time since remission were the strongest predictors of AtA. Our findings suggest that health care interventions with older women in breast cancer remission still living in the community may benefit from clearly including these predictors of AtA, as they are relevant for promoting older women’ s aging well.