Testing Theoretical Explanations of Intention to Seek Care for a Breast Cancer Symptom1

The purpose of this research was to test theoretical explanations of intention to seek care promptly for a breast cancer symptom. Psychosocial variables (affect, expectations, values, and norms), habit, and facilitating conditions (e.g., insurance) regarding care seeking were proposed to influence intention to seek care promptly. Whether psychosocial variables and habit influenced intention directly or in interaction with facilitating conditions remained unclear. Other variables (i.e., clinical and demographic) were proposed to influence intention by mediation through the theoretical variables. Community-dwelling women without history of breast cancer (N= 99) responded to a questionnaire to assess study variables. In a hierarchical set regression, intention was first regressed on psychosocial variables, habit, and full insurance coverage for care, then on terms representing interactions of insurance coverage with psychosocial variables and habit, and lastly on clinical and demographic variables. Findings revealed that (a) anxiety (measure of affect), utility, (the product of expectations and values), and habit were related to intention, (b) having full insurance coverage did not moderate these relationships, and (c) after controlling for theoretical variables, family history of breast cancer was related inversely to intention. Implications for theory, research, and practice are delineated.     

Personality predictors of the time course for lung cancer onset

Numerous findings suggest that personality is linked to the incidence and experience of negative health outcomes. More specifically, trait negative affect is negatively related to a number of health outcomes. The current study expands our understanding of the link between personality and disease by examining the time course for lung cancer onset. In a sample of patients who had recently undergone surgical resection for lung cancer, a variety of negative affect related personality variables were assessed to determine their relationship with age at surgery. After controlling for smoking behavior, it was found that trait negative affect was associated with time course for lung cancer onset, such that those with higher (vs. lower) levels of trait negative affect manifested lung cancer earlier in their lives. Thus, trait negative affect represents an independent risk factor among those prone to lung cancer (i.e., smokers).     

Validating an older adult driving behaviour model with structural equation modelling and confirmatory factor analysis

The Multilevel Older Persons Transportation and Road Safety (MOTRS) model postulates a role for demographic, functional, and psychosocial factors in driving self-regulation. This study formally tested the constructs of the MOTRS model, and its ability to account for variation in older adult’s driving self-regulation. Four exogenous constructs dealing with sociodemographic and driving-related variables (driving space, dependency on other drivers, health, and driving performance) and three endogenous constructs of psychosocial appraisals (driving confidence, attitudes and beliefs towards driving) were used to predict driving self-regulation. A sample of 277 Australian drivers, aged 65 years or over, completed standardised questionnaires to assess these variables. Structural equation modelling was used to evaluate one of the model’s assumptions. Findings established that sociodemographic and driving-related factors influence older adults’ driving self-regulation by impacting psychosocial variables. A re-specified model accounted for 75% of the variance in self-reported driving self-regulation. When other variables were considered, attitude towards driving was the strongest single predictor of driving self-regulation. These findings provide an initial partial validation of the MOTRS model. The results indicate that psychosocial variables are important determinants of driving self-regulation by older adults. This model could guide future research into older adults’ driving self-regulation.     

Personality factors as predictors of pathological gambling

The aim of this study was to investigate the relationship between different personality variables and pathological gambling (PG). The NEO-FFI and measures of impulsivity and sensation-seeking were administered to a sample of pathological gamblers (n = 90) and to a contrast group of non-pathological gamblers (n = 66) matched on sex and age. Gender, age, education level and the personality variables were entered into crude and adjusted logistic regression analyses with PG-status as the dependent variable. The results showed that educational level and all personality variables were significant predictors of PG in the crude analyses, however only four of the 12 significant predictor variables (Neuroticism, Openness, Impulsivity, and need for Stimulus Intensity) remained significant in the adjusted analysis. All predictor variables accounted for 71% of the variance in PG-status. Clinical implications of the findings are discussed.     

Personality,stress, smoking,and genetic predisposition as synergistic risk factors for cancer and coronary heart disease

Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).     

Personality, stress, smoking, and genetic predisposition as synergistic risk factors for cancer and coronary heart disease.

Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).     

Prevalence,correlates, and psychosocial outcomes of sport participation in young adult cancer survivors

Young adult cancer survivors (YACS) face unique challenges from their disease and treatments that may influence their sport participation choices as well as their psychosocial response.ObjectivesTo examine the prevalence, correlates, and psychosocial outcomes of sport participation in YACS.DesignA provincial, population-based mailed survey of 588 YACS in Alberta, Canada, was completed in May 2008 and included measures of sport participation, psychosocial health (depression, self-esteem, and stress), quality of life (QoL), and medical and demographic variables.ResultsOne third (32.5%) of YACS reported participating in a sport in the past month with the most common being golf (40.8%) and ice hockey (8.3%). YACS participating in sport reported an average frequency of 1.7 (SD = 1.0) days/week and an average duration of 119 min/session (SD = 68) for a total of 189 (SD = 164) min/week. Independent t-tests showed that YACS who participated in sport reported better psychosocial health and QoL including physical QoL (p < 0.001), mental QoL (p < 0.001), self-esteem (p < 0.001), depression (p < 0.001), and stress (p < 0.001). In multivariate regression analysis, 8.5% (p < 0.001) of the variance in sport participation was explained by being male (β = 0.17, p < 0.001), Caucasian (β = 0.15, p = 0.001), in better general health (β = 0.15, p < 0.001), and having a normal body mass index (β = ?0.10, p = 0.024).Discussion/conclusionsSport participation is associated with better psychosocial health and QoL in YACS but only a third participated in the past month. Randomized controlled trials examining sport as an intervention strategy to increase physical activity and improve health outcomes in YACS are warranted.     

The Impact of Cancer on Psychological and Social Outcomes

Cancer is now the biggest cause of mortality worldwide. Although the debilitating physical symptoms of cancer have long been known, the psychological and social impacts of cancer have become the subject of examination only relatively recently. The psychological outcomes that have been examined are primarily negative emotional variables, e.g., anxiety, but emerging research has focused on positive emotional variables, e.g., post‐traumatic growth, or cognitive outcomes. In this article, we provide a synthesis of reviews that have addressed the psychosocial impact of cancer. The framework for this synthesis is provided by a conceptualisation in which the presence of cancer impacts on psychosocial outcomes either directly or via mediating variables, including physical symptoms and treatment, and that this effect may be moderated by several variables, some characteristic of the person with cancer (demographic or personality‐related variables) and some characteristic of their environment (social support and medical variables). We also briefly examine the impact of cancer on the broader family unit following cancer diagnosis, treatment, survivorship and bereavement. We conclude that the heterogeneity of the cancer experience highlights the need for theoretically driven research and consistency in measurement approaches to determine mechanisms by which cancer exerts influence on psychosocial outcomes. This would allow development and delivery of targeted psychological interventions and a clearer delineation of the roles of the various parties, including clinical psychologists, family members and policymakers.     

Tracking the psychosocial predictors of older individuals' television uses

The elderly spend considerable amounts of time with mass media, but little is known about the psychology of their viewing habits. This study compared the relative impact of social, structural, and psychosocial variables on the television uses of elderly viewers. The results of a survey of 113 older respondents indicated that psychosocial factors accounted for variance above and beyond that of demographic and situational factors in viewing of television entertainment programs, parasocial programs (e.g., soap operas), as well as in watching of television for companionship purposes. Emotional loneliness and locus of control proved particularly significant predictors of television behavior.     

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.     

Social cognitive predictors of competitive level among athletes with physical disabilities

ObjectiveTo test a model of Social Cognitive Theory variables for predicting participation in higher versus lower levels of parasport competition. Information on modifiable factors associated with parasport competition would help parasport coaches and organizations transition recreational and developmental-level athletes to more competitive streams of participation.DesignCross-sectional survey.MethodParticipants were 95 parasport athletes with physical disabilities that cause mobility impairment (74% male; mean age = 34.36 ± 12.41). Measures of Social Cognitive Theory constructs were assessed via online questionnaires. Path analysis was used to test the proposed model.ResultsThe model explained 12% of the variance in level of sport participation. Peer support for sport was a significant predictor of self-regulatory efficacy (β = .22, p < .05) which, in turn, was positively related to outcome expectations (β = .43, p < .001), and self-regulation (β = .43, p < .001). Self-regulatory efficacy was the only significant predictor of level of sport participation (β = .26, p < .05). There were no significant indirect effects between social support and competitive status (p > .05).DiscussionSocial Cognitive Theory provides a reasonable basis for formulating a model of psychosocial factors related to parasport competitive status. Other relevant factors should be taken into consideration in subsequent studies. Parasport coaches and organizations may benefit from leveraging peer support to help bolster athletes' self-regulatory efficacy to levels conducive to participation in higher competitive sport streams.     

Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

Objective: Communication of cancer information is an important element of cancer control, but cancer fear may lead to information avoidance, especially when coping is low. We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress.

Design: Cross-sectional survey of 1258 population-based adults (58–70 years) in England.

Main outcome measures: Cancer fear (intensity and frequency), perceived psychosocial stress and cancer information avoidance. Control variables were age, gender, ethnicity, marital status and education.

Results: A quarter (24%) of respondents avoided cancer information. Ordinal logistic regression analyses showed main effects of psychosocial stress (OR = 1.17, 95% CI 1.07–1.29) and cancer fear: cancer information avoidance was lowest in those with no cancer fear (13%), followed by those with moderate (24%; OR = 2.15, 95% CI: 1.49–3.12), and high cancer fear (35%; OR = 3.90, 95% CI: 2.65–5.73). In the adjusted model, the interaction between cancer fear and stress was significant (OR = 1.14, 95% CI 1.004–1.29, p < .05): 40% of those with high fear/high stress avoided cancer information compared with 29% with high fear/low stress.

Conclusion: Cancer fear and psychosocial stress interact to produce disengagement with cancer-related information, highlighting the importance of affective processes to cancer control efforts.     

Identifying distinct sets of predictors of specific functions of autobiographical memory

ABSTRACT

Grounded in the ecological approach, research has charted several adaptive functions of autobiographical remembering. Each represents a rather different psychosocial domain (i.e., self, social, directive). The goal of this research was to determine the contributions of each of a set of variables, controlling for all others, in predicting use of autobiographical memory to serve each specific function. In two studies, participants (N?=?100; N?=?195) rated frequency of functional use of specific event memories and completed a brief battery of memory-related measures. Most Study One results were replicated in Study Two. Self-relevance of memories was related to their functional use regardless of domain. Each function was also, however, predicted by a unique set of variables consistent with its use in a given psychosocial domain. Findings emphasise how a combination of factors come into play to allow humans to use autobiographical memory to serve various different functions in navigating daily life.     

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.     

Children and Adolescents of Cancer Patients: The Impact of Cancer on the Family

In this article, extant literature was reviewed to examine the impact of parental cancer on the family. Many researchers and scholars have hypothesized that parental illnesses, like cancer, can affect all levels of the family system. However, most psychosocial research to date has focused on how cancer affects the patient and the couple. Consequently, little is known about how parental cancer affects the psychosocial development of children and adolescents. Therefore, research is needed to explore how children and adolescents are negatively impacted or protected from the effects of living with a parent who has cancer. More specifically, longitudinal studies that examine the mechanisms by which the cancer affects children's and adolescents' functioning can help physicians and family therapists clinically intervene in more efficacious ways.     

Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity

Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n = 54) and the other with BED (OB-BED, n = 48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy.     

Psychosocial correlates of bulimic symptomatology among male athletes

ObjectivesTo examine the relationship of four psychosocial constructs – body dissatisfaction, restrained eating, drive for muscularity, and negative affect – that have been identified as potential risk factors for bulimic symptoms in male athletes.DesignWe used a cross-sectional design and self-report questionnaires.MethodsParticipants were 203 male, NCAA Division I athletes who were drawn from three different U.S. universities and who competed in 17 different varsity sports. Athletes completed self-report measures of body satisfaction, dietary restraint, drive for muscularity (i.e., muscularity behaviors, muscular body image), negative affect (i.e., fear, hostility, guilt, sadness), and bulimic symptomatology.ResultsAfter controlling for the effects of body mass and social desirability, hierarchical regression analysis showed that the psychosocial variables explained an additional 21% of the variance in bulimic symptoms. In the full model, engaging in muscle building behaviors (β = .16), such as lifting weights, as well as restricting caloric intake (β = .33) were associated with higher levels of bulimic symptomatology; negative affect and body dissatisfaction were not.ConclusionsMale athletes' bulimic symptomatology is best explained by the extent to which they report engaging in behaviors to become leaner (i.e., less body fat) and more muscular.     

Family and psychosocial predictors of obsessive compulsive disorder in a community sample of young adolescents

A two-stage epidemiologic study conducted between 1986 and 1988 in the southeastern United States investigated family and psychosocial predictors of obsessive compulsive disorder (OCD) and subclinical OCD in young adolescents. In the first stage, a life-event schedule and a family adaptability and cohesion scale were administered to a community sample of 3,283 adolescents. In stage two, the Schedule for Affective Disorders and Schizophrenia in School Age Children and the Children's Global Assessment Scale were administered to 488 mother-child pairs. In multivariable models family cohesion was the only significant correlate of OCD (odds ratio=0.95, 95% confidence interval 0.91–0.98). Gender, race, age, socioeconomic status, guardian status, adaptability, undesirable life events and desirable life events were not found to be significant predictors of OCD in models adjusting for cohesion. Note of the above variables were significantly associated with subclinical OCD. However, separate analyses of the 41 individual life events indicated seven specific events were significantly associated with OCD or subclinical OCD. These findings are at odds with the theory that overinvolvement of family members is a risk factor for OCD, though an association with overly rigid family structure cannot be eliminated based on these data. Further exploration of family characteristics is warranted.     

Distress and Psychosocial Needs of a Heterogeneous High Risk Familial Cancer Population

In order to assess the levels of distress and psychosocial support needs of a high risk population, we undertook a study to look at both the objective and subjective levels of distress and the wants and needs of individuals from a high familial cancer risk population. Three hundred and eighteen individuals (160 affected, 158 unaffected) completed several distress and psychosocial needs questionnaires (including the Brief Symptom Inventory-18). Sixty key informants were also surveyed about their perspective on the support needs of this population. In the largely female (90%), largely HBOC syndrome group (approximately 90%), 20% had significant levels of generalized distress, with no significant differences between affected and unaffected individuals. Generalized distress was also not significantly different as a function of mutation status. Individuals who received inconclusive test results, however, were more likely to indicate somatic symptoms of distress. Those individuals who did not have social support were more likely to be those who had never had cancer and who either had a mutation, received inconclusive test results, or were not tested. Key informants were most likely to indicate that patients need more support. These results provide evidence for the importance of establishing regular psychosocial distress screening, including a focus on somatic symptoms, in such high risk populations.