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.     

Social Support,Conflict, and Integration Among Women Living With HIV/AIDS1

The relationship between depressive symptoms and perceptions of available social support, social conflict, and subjective social integration were examined as part of a psychosocial study of Puerto Rican, African American, and non‐Hispanic White women living with HIV/AIDS (N= 146) in New York City. Lower levels of subjective social integration and higher levels of social conflict were associated with more depressive symptoms. Perceived availability of social support was not significantly associated with depression in comparison with these other forms of support. No evidence was found for a stress‐buffering or a stress‐amplification effect. Significant ethnic differences in levels of social integration and social conflict also were noted. Results suggest that intervention efforts should go beyond addressing support to further address the conflict and lack, of integration experienced.     

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.     

The Benefits of Goal Adjustment Capacities for Well‐Being Among Women With Breast Cancer: Potential Mechanisms of Action

Breast cancer can seriously disrupt a person's important life goals. As such, the ability to adjust one's goals may be critical for well‐being. The present study investigated the relationships between disengagement/reengagement capacity and well‐being among women with breast cancer, as well as several potential mechanisms (intrusive thoughts, life purpose, and physical activity) that could explain these relationships. The sample consisted of 230 women with early‐stage (n = 172) or late‐stage (n = 58) breast cancer, who were followed prospectively for 8 months. Well‐being measures consisted of global mental health, perceived physical health, positive/negative affect, and sleep efficiency. Disengagement capacity did not predict any outcome variable. In contrast, reengagement capacity prospectively predicted changes in global mental health, positive affect, negative affect, sleep efficiency, life purpose, and physical activity. Life purpose mediated the prospective relationship between reengagement capacity and multiple aspects of well‐being. The relationships between purpose and positive/negative affect were reciprocal over time. Results also suggested that physical activity is not a mediator, but is in fact a result of the effect of reengagement capacity on well‐being. The results demonstrate that reengagement capacity is important for well‐being among women with breast cancer.     

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.     

Book Reviews of Group Psychotherapy for Women With Breast Cancer and The Breast Cancer Notebook: The Healing Power of Reflection

Book reviewed in this article: Group Psychotherapy for Women With Breast Cancer by James L. Spira & Geoffrey M. Reed (2003). The companion book is The Breast Cancer Notebook: The Healing Power of Reflection by Ava Louise Stanton & Geoffrey M. Reed (2003).     

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.     

Postpartum Depression Among Women With Disabilities: A Multicultural Counseling Perspective

Postpartum depression is an important mental health problem for women, and women with disabilities are at greater risk than are women without disabilities. This article explores the disability‐specific contextual, environmental, social, and systemic causes of postpartum depression from an ecological perspective. I aim to help counselors develop a nonpathologizing, multicultural counseling–rooted approach and to prepare counselors to work effectively with this unique population. Implications of multicultural counseling tenets and advocacy are also examined for best practices. La depresión posparto es un problema de salud mental importante para las mujeres, y el riesgo es mayor para las mujeres con discapacidades que para las mujeres sin discapacidades. Este artículo explora las causas contextuales, sociales, del entorno y sistémicas de la depresión posparto relacionadas con la discapacidad desde una perspectiva ecológica. Mi objetivo es ayudar a los consejeros a desarrollar un enfoque no patológico basado en la consejería multicultural y preparar a los consejeros para trabajar de forma efectiva con esta población singular. También se examinan las implicaciones de los principios de la consejería multicultural y la defensoría para las prácticas recomendadas.     

Preferences for Spousal Support Among Individuals With Cancer1

Although it is known that individuals have preferences for different forms or amounts of social support from others when dealing with life events, such preferences have not been subject to extensive empirical examination. We examined preferences for spousal emotional and instrumental support, as well as preferences for spousal control-encouraging responses, among 151 individuals with cancer. Dispositional and situation-specific factors were placed into a hypothetical model predicting support preferences. Results confirmed predictions: Preferences for emotional and instrumental aspects of support were related to dispositional (affiliative need), person (gender), and contextual (disease impairment) variables. As predicted, higher affiliative need predicted higher preference for emotional support. However, functional impairment did not predict preferences for more instrumental support, and this variable only predicted preferences for more emotional support among female patients. Individuals’ preferences for control encouragement from their spouses were associated with attributions of personal responsibility for solving general life problems and indirectly associated with internal locus of control. These results provide an initial conceptual model for understanding cancer patients’ preferences for support.     

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.     

Intimate Partner Violence Among Transitional-Aged Women With and Without Disabilities: Implications for Social Work Practice

Although women with disabilities are at increased risk for intimate partner violence (IPV), little is known about how this phenomenon impacts transitional-aged young women with disabilities who are still trying to master the developmental challenges of adolescence. This study explores risk factors for and prevalence of IPV by drawing on a population-based sample of women ages 18–21 with (N = 1,616,207) and without (N = 7,554,064) self-reported disabilities. Findings suggest that risk factors for IPV were more prevalent among sample members, as was past year experience of IPV. This study has implications for school social workers and disability service providers who interact with this population.     

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.     

Directionality of the Association Between Social Support and Posttraumatic Stress Disorder: A Longitudinal Investigation1

This study examined the nature of the association between social support and posttraumatic stress disorder (PTSD) symptomatology among 2,249 male veterans of the 1990‐1991 Gulf War. Using structural equation modeling, a cross‐lagged panel analysis indicated a strong negative relationship between PTSD at Time 1 and social support at Time 2, while social support at Time 1 did not predict PTSD at Time 2. Findings suggest that, over time, interpersonal problems associated with PTSD may have a detrimental influence on the quality and quantity of available social support resources. It is recommended that greater focus be placed on the interpersonal skills of those suffering from PTSD.     

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.