Posttraumatic Stress Symptoms and Stressful Life Events Predict the Long-term Adjustment of Survivors of Childhood Cancer and Their Mothers

Objectives: To examine prospectively the impact of posttraumatic stress symptoms (PTSS) in response to childhood cancer and treatment on general adjustment while accounting for the role of other stressful life events and appraisal of life threat and treatment intensity. Methods: As part of a larger study assessing PTSS, 56 childhood cancer survivors, aged 8 to 18, and 65 mothers completed self-report measures of PTSS and appraisal of the intensity and life threat associated with cancer treatment at time 1 and self-report measures of stressful life events and general adjustment at time 2 (approximately 18 months after time 1). Results: For child survivors and their mothers, posttraumatic stress at time 1 significantly predicted general adjustment at time 2, over and above the significant contribution of lifetime stressful events. The life events variable did not function as a mediator in the association of PTSS and general adjustment. Conclusions: Trauma responses to childhood cancer and its treatment have implications for the long-term adaptation of children and their families. Early signs and symptoms of posttraumatic stress and stressful life experiences require early assessment and intervention.     

Posttraumatic Growth, Posttraumatic Stress Symptoms and Mental Health Among Coronary Heart Disease Survivors

The present study aimed to estimate posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among heart disease survivors and examine whether PTG moderates the association between PTSS and mental health. Data from 82 myocardial infarction and acute coronary artery bypass graft survivors (aged 46–82) was obtained at admission to a cardiac rehabilitation unit. Mental status was assessed by the PTSD Inventory, Posttraumatic Growth Inventory (PTGI), Mental Health Inventory and Health Related Quality of Life (HRQOL). 17.1 % of the participants suffered significantly from PTSS and most of the study sample (71.2 %) reported PTG. PTSS were positively associated with PTG and psychological distress and negatively with well-being and HRQOL. PTG moderated the association between PTSS and most mental health outcomes. We conclude that posttraumatic growth may attenuate the negative effect of posttraumatic stress symptoms on mental health.     

Health behavior, knowledge and attitudes among Swedish university students

A range of health behaviors was related to beliefs concerning health practices and health knowledge. A questionnaire dealing with health-related practices, health beliefs and knowledge of health risk factors was answered by 166 male and 179 female students aged 18–30 years at Stockholm University. Female students reported engaging in better health behavior than males. Beliefs about the importance of health behaviors were closely related to their frequency of occurrence. There was only a weak relationship between health behaviors and knowledge of specific health matters. It is concluded that health attitudes rather than health knowledge determine health behavior.     

Social comparisons and quality of life among survivors of childhood cancer and their mothers

Abstract

Sixty-three survivors of childhood cancer (mean age 17 years), currently well and off-treatment, and their mothers were interviewed individually about their experiences and the impact of their illness on their lives. Survivors also completed four questionnaire measures of different aspects of quality of life (perceptions of illness experience, future worries, health problems and body image satisfaction), whereas mothers recorded their perceptions of their child's quality of life on the same four scales. These scales showed good internal consistency and convergent validity for both survivors and mothers. Mothers also completed a measure of their own quality of life (the SF-36). The interviews with both survivors and mothers were content-analysed for statements expressing social comparisons. These statements were coded according to whether the comparison implied a favourable, neutral or unfavourable evaluation of the individual survivor. Mothers who made a higher proportion of unfavourable comparisons reported worse adjustment for their child on all four scales and described their own quality of life more negatively. Among survivors, those who made a higher proportion of unfavourable comparisons gave significantly more negative self-ratings on one of the four scales. Correlations between survivors' and mothers' ratings on the four scales were positive, but comparatively low. This reinforces concerns about using parents as proxy judges of young people's quality of life, although the correlations were more satisfactory in the case of younger rather than older (>18.5 years) survivors. Mothers who rated their own quality of life as less satisfactory reported more problems for their child on all four scales, irrespective of how the survivors described themselves.     

Relationship between religious beliefs and post-traumatic growth in patients with cancer in southeast of Iran

Information about religious beliefs and post-traumatic growth is limited in Iranian cancer patients. This study was conducted to determine the relationship between religious beliefs and post-traumatic growth among cancer patients in Iran. This correlational study included a convenience sample of 200 eligible cancer patients who were hospitalized in the oncology wards and outpatient clinics. Using Post-traumatic Growth Inventory (PTGI) and Religious Beliefs Scale, data were collected. Findings showed that, the total mean score of PTG was 93.81 (SD?=?15.25). Among the categories, the lowest score belonged to “appreciation of life” component (7.67±1.99), and the highest score belonged to “spiritual change” component (67.49 ± 17.78). The mean score of Religious Beliefs Scale was 67.20 (12.35). Post-traumatic growth positively correlated with religious beliefs (r?=?.345; p?=?.001). The results suggest that, information about religious beliefs and post-traumatic growth should be included in the continuous and in-service education of cancer patients and nurses who work with them.     

Pathogenic Beliefs Mediate the Relationship Between Perceived Negative Parenting and Psychopathology Symptoms

Negative parenting style, such as abuse, neglect, and intrusiveness, is significantly related to subsequent development of psychopathology. Here we sought to examine pathogenic beliefs as a potential mechanism of change. We explored whether pathogenic beliefs help explain the relationship between perceived negative parenting style and common psychopathology symptoms. This study assessed the psychometric properties of the self-report Pathogenic Beliefs Scale and tested its mediating effect on the relationship between negative parenting and psychopathology. A community sample of 732 adults completed an online survey that included measures of perceived negative parenting style (MOPS), pathogenic beliefs (PBS), and a transdiagnostic measure of common indicators of psychopathology (anxiety, low self-esteem, emotional instability, pessimistic attitude, and depression). Results showed that pathogenic beliefs were significantly associated with negative parenting experiences in childhood and adult psychopathology symptoms. Moreover, pathogenic beliefs mediated the relationship between negative parenting style and psychopathology. Implications for clinical practice are discussed.     

Thought Control: Is It Ability, Strategies, or Both That Predicts Posttraumatic Symptomatology in Victims of Interpersonal Trauma?

Cognitive models of PTSD have implicated thought control in the development, maintenance, and recovery from PTSD. The present study extends previous research on thought control (ability and strategies) and it’s relation to posttraumatic stress symptoms (PTSS) in a sample of interpersonal trauma (IPT) survivors. Results revealed that weak thought control ability mediated the relationship between accumulated discrete IPT experiences and PTSS severity. Weak thought control ability was associated with greater use of thought control strategies, and thought control strategies of punishment and suppression added significant variance over and above the effects of accumulated IPT experiences and thought control ability in predicting PTSS severity. Furthermore, weak thought control ability was related to greater PTSS severity through the use of punishment and suppression thought control strategies. The present findings extend previous research and provide further support for theoretical assumptions of current treatment approaches for PTSD.     

Paths from core belief disruption to post-traumatic stress symptoms and post-traumatic growth among Korean undergraduates: The mediating role of rumination

The post-traumatic growth (PTG) model proposes that cognitive processing is a key mechanism that leads to growth in the aftermath of traumatic events. Building upon the PTG model, the present study examined the paths from the disruption of core beliefs to post-traumatic stress symptoms (PTSS) and PTG via intrusive and deliberate rumination. The sample includes 370 Korean undergraduate students who reported at least one highly stressful experience in their lifetime. Structural equation modeling demonstrated that disruption of core beliefs predicted PTG both directly and indirectly through multiple pathways: via deliberate rumination, intrusive rumination, and the path from intrusive to deliberate rumination. The disruption of core beliefs positively predicted PTSS only through intrusive rumination. No bivariate relationship was found between PTSS and PTG. These findings support the different roles of intrusive rumination and deliberate rumination in mediating the paths from disruption of core beliefs to PTSS and PTG. Implications and limitations of this study were discussed.     

Irrational beliefs and psychological needs

Studied the relationship between irrational beliefs and 15 psychological needs described by Murray. The Irrational Beliefs Test (IBT) and the Adjective Check List (ACL) were administered to 46 high school students and 50 adults. Results of stepwise multiple regression analyses indicated that five IBT scales and IBT Full-Scale were significantly associated with psychological needs. It was concluded that pathological behavior could not be readily predicted on the basis of irrational beliefs. It was further concluded that Ellis' model of personality obtained additional validating evidence.     

Some correlates of health locus of control among multicultural individuals

The relationship of locus of control to depression, anxiety, hostility, and physical health was assessed in a sample of multicultural college students (N = 162). Powerful Others Health Locus of Control was correlated with depression, anxiety, hostility, and recent physical symptoms while Chance Health Locus of Control (CHLC) was correlated with all of the above as well as chronic physical symptoms and major health problems. When controlling for a variety of health risk factors (viz., age, sex, body mass, exercise, smoking, salt, alcohol, and caffeine), only CHLC remained significant in the physical health models. Results support the cognitive model of mental health which emphasize the importance of adaptive beliefs. Specifically, they suggest that issues about control are related to negative affect and indicate that the often-cited relationship of an external locus of control to depression and anxiety also holds for hostility. The findings do not, however, support the view that anxiety and depression are associated with different types of external locus of control but rather suggest a unified set of locus of control beliefs underlying the three types of negative affect. In addition, evidence is provided for the external validity of the Multidimensional Health Locus of Control (MHLC) Scales with respect to mental health. Further, the results indicate that belief about one’s health may play a significant role in one’s physical health and that the health behavior model of the relationship between locus of control and physical health is insufficient to explain the relationship. As the Chance and Powerful Others MHLC scales were not related to health habits in this sample but were related to mental health (viz., depression, anxiety, and hostility), locus of control beliefs may be related to physical health via their relationship with mental health.     

Ethno-culture, anxiety, and irrational beliefs

Ellis, Beck, and others in the cognitive therapy tradition maintain that there is a strong correlation between irrational beliefs and nonpsychotic mental health problems such as anxiety. Numerous studies have found that irrational beliefs are correlated with high trait anxiety. In a multi-cultural sample (n = 250; 46.7% Caucasian, 23.6% Asian, 23.6% multi-cultural, and 6.1% of other ethno-cultural backgrounds), these findings are replicated. Profile analysis (MANOVA) results reveals significant relationships between high trait anxiety and seven of the ten irrational beliefs scales on Jones' Irrational Belief Test. Asians are found to be the most anxious, and the relationship between ethno-culture and irrational beliefs was significant on three of the ten scales, with Asians having more irrational beliefs than Caucasians or multi-cultural individuals. However, no interaction is found between anxiety and ethno-culture in their relationship to irrational beliefs. Thus, these results reveal that there are ethno-cultural differences in anxiety and irrational beliefs. Clinical implications of the findings are discussed.     

Ethno-culture, anxiety, and irrational beliefs

Ellis, Beck, and others in the cognitive therapy tradition maintain that there is a strong correlation between irrational beliefs and nonpsychotic mental health problems such as anxiety. Numerous studies have found that irrational beliefs are correlated with high trait anxiety. In a multi-cultural sample (n = 250; 46.7% Caucasian, 23.6% Asian, 23.6% multi-cultural, and 6.1% of other ethno-cultural backgrounds), these findings are replicated. Profile analysis (MANOVA) results reveals significant relationships between high trait anxiety and seven of the ten irrational beliefs scales on Jones' Irrational Belief Test. Asians are found to be the most anxious, and the relationship between ethno-culture and irrational beliefs was significant on three of the ten scales, with Asians having more irrational beliefs than Caucasians or multi-cultural individuals. However, no interaction is found between anxiety and ethno-culture in their relationship to irrational beliefs. Thus, these results reveal that there are ethno-cultural differences in anxiety and irrational beliefs. Clinical implications of the findings are discussed.     

Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans

Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.     

Perceived positive and negative consequences after surviving cancer and their relation to quality of life

Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health‐related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer‐related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty‐one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN‐52 self‐reported version. Data were analysed using mixed methods approach. Overall, 87.8% of the studied sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer‐related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well‐being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well‐being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.     

Neurodevelopmental consequences of pediatric cancer and its treatment: applying an early adversity framework to understanding cognitive,behavioral, and emotional outcomes

Today, children are surviving pediatric cancer at unprecedented rates, making it one of modern medicine’s true success stories. However, we are increasingly becoming aware of several deleterious effects of cancer and the subsequent “cure” that extend beyond physical sequelae. Indeed, survivors of childhood cancer commonly report cognitive, emotional, and psychological difficulties, including attentional difficulties, anxiety, and posttraumatic stress symptoms (PTSS). Cognitive late- and long-term effects have been largely attributed to neurotoxic effects of cancer treatments (e.g., chemotherapy, cranial irradiation, surgery) on brain development. The role of childhood adversity in pediatric cancer – namely, the presence of a life-threatening disease and endurance of invasive medical procedures – has been largely ignored in the existing neuroscientific literature, despite compelling research by our group and others showing that exposure to more commonly studied adverse childhood experiences (i.e., domestic and community violence, physical, sexual, and emotional abuse) strongly imprints on neural development. While these adverse childhood experiences are different in many ways from the experience of childhood cancer (e.g., context, nature, source), they do share a common element of exposure to threat (i.e., threat to life or physical integrity). Therefore, we argue that the double hit of early threat and cancer treatments likely alters neural development, and ultimately, cognitive, behavioral, and emotional outcomes. In this paper, we (1) review the existing neuroimaging research on child, adolescent, and adult survivors of childhood cancer, (2) summarize gaps in our current understanding, (3) propose a novel neurobiological framework that characterizes childhood cancer as a type of childhood adversity, particularly a form of early threat, focusing on development of the hippocampus and the salience and emotion network (SEN), and (4) outline future directions for research.     

Conspiracist beliefs,intuitive thinking,and schizotypal facets: A further evaluation

This study examined whether thinking style mediated relationships between belief in conspiracy and schizotypy facets. A UK-based sample of 421 respondents completed the Generic Conspiracist Beliefs Scale (GCBS), Oxford-Liverpool Inventory of Feelings and Experiences Short (O-Life), and measures indexing preferential thinking style (proneness to reality testing deficits and Need for Cognition). Path analysis revealed direct and indirect relationships between Conspiracy Beliefs and schizotypy facets. Unusual Experiences had a direct effect on Conspiracy Beliefs and predicted Reality Testing and Need for Cognition. Preferential thinking style mediated the schizotypy-belief in conspiracy relationship. This pattern of results (higher experiential-based processing and lower Need for Cognition) was consistent with intuitive thinking. Introverted Anhedonia and Impulsive Nonconformity predicted Reality Testing and had indirect effects on Conspiracy Beliefs. Finally, Reality Testing predicted Conspiracy Beliefs, whereas Need for Cognition did not. These results confirm that cognitive processes related to thinking style mediate the schizotypy-conspiracist beliefs relationship.     

Development of the Mental Health Locus of Control and Mental Health Locus of Origin Scales

The Mental Health Locus of Control (MHLC) Scale is an area-specific measure of locus of control expectancies designed to predict mental health related behaviors, particularly those occurring in treatment situations. The discriminant validity of the MHLC, in contrast with Rotter's 1-E measure of generalized expectancies, was demonstrated with two mental health related variables: beliefs concerning etiology of psychopathology, and information about abnormal psychology. Beliefs about etiology were measured by the Mental Health Locus of Origin (MHLO) Scale. The primary hypothesis, that individuals with 'endogenous' beliefs about etiology tend to have 'external' expectations for the client's role in treatment, was supported by a statistically significant (p < .001) correlation between the MHLC and MHLO Scales.     

The presence of magical thinking in obsessive compulsive disorder

Two research groups have raised the possibility that magical ideation may be a fundamental feature of obsessive-compulsive disorder. It has been proposed to underlie thought action fusion and superstitious beliefs. In this study, the Magical Ideation scale, the Lucky Behaviours and Lucky Beliefs scales, the Thought Action Fusion-Revised scale, the Padua Inventory, and the Obsessive Compulsive Inventory-Short Version were completed by 60 obsessive compulsive patients at a hospital clinic. Of all the measures, the Magical Ideation (MI) scale was found to be the most strongly related to obsessive compulsive symptoms. Large and significant relationships between MI scores and the measures of OCD were obtained even when alternative constructs (Lucky Behaviours, Lucky Beliefs, Thought Action Fusion-Revised scales) were held constant. No other variable remained significantly related to the Obsessive Compulsive Inventory-Short Version when magical ideation scores were held constant. The findings suggest that a general magical thinking tendency may underpin previous observed links between superstitiousness, thought action fusion and OCD severity.     

Beliefs about Memory as a Mediator of Relations between Metacognitive Beliefs and Actual Memory Performance

The goal of the present study was to investigate relationships between personal beliefs about memory, metacognitive beliefs, and actual memory performance. One hundred thirty-seven participants' (aged 20 to 60 years) metacognitive beliefs were measured using the Metacognition Questionnaire (MCQ-30), memory beliefs were measured using the Personal Beliefs about Memory Instrument (PBMI), and an episodic memory task was used to measure actual memory performance, memory predictions, and postdictions. Younger adults had lower scores on the positive beliefs subfactor of the MCQ-30, higher scores on retrospective change and control subfactors of the PBMI, and outperformed middle-aged adults on recall and recall postdiction. Path analysis showed that individuals' beliefs about memory mediate the relationship between metacognitive beliefs and actual memory performance. Specifically, low lack of confidence (or less worry) in one's own memory and attentional capabilities was related to higher memory performance and positive personal beliefs regarding specific memory ability mediated relationship.     

The free will and punishment scale: Efficient measurement and predictive validity across diverse and nationally representative adult samples

Theoretically, attitudes about freedom and punishment can shape people’s decisions and cause pernicious disagreements (e.g., political policies). Several scales measure free will beliefs, partially to help understand disagreements about theoretical and practical issues. We contribute to these efforts by directly comparing existing measures and by introducing a short measure of free will related attitudes. Studies 1, 2, and 3 (Ns = 221, 225, 244) factor analyzed all items in existing scales of free will and moral responsibility, resulting in two prominent factors: Beliefs in Free Will and Beliefs in Punishment. Study 4 (N = 269) presents evidence for the 2-factor structure from a nationally representative sample. Study 5 (N = 108) gives evidence of the utility of the Free Will and Punishment scale in predicting free will relevant beliefs and attitudes. As such, the Free Will and Punishment scale is likely useful when longer instruments are not practically possible.