The Role of Optimism,Social Constraints,Coping, and Cognitive Processing in Psychosocial Adjustment Among Breast Cancer Survivors

The social-cognitive processing model suggests that a socially constrained environment may impede adjustment to a chronic illness. The present study primarily investigated the mediating psychological pathways through which social constraints on cancer-related disclosure, low optimism, disengagement-oriented coping, and brooding could be associated with low levels of psychosocial adjustment. One hundred twenty-five female breast cancer survivors participated in a cross-sectional study. Path analysis was used to examine the proposed model. Low optimism, increased social constraints, and higher levels of brooding appeared to be risk factors for poor psychosocial adjustment to breast cancer. Disengagement-oriented coping and brooding partially mediated the relationship between social constraints and adjustment. Brooding totally mediated the relationship between disengagement-oriented coping and adjustment. The current findings provide support for the value of the social-cognitive processing model among breast cancer survivors. The mapping of psychological pathways of adjustment to breast cancer may have useful clinical implications for better adjustment outcomes.     

Intrusion, avoidance, and daily negative affect among couples coping with prostate cancer: a dyadic investigation

In the present study we examined how husbands' and wives' intrusive thoughts of prostate cancer (i.e., thinking about it when not meaning to) and avoidance (i.e., efforts to not think about cancer) related to their own and each other's average negative affect over a subsequent 14-day period. We examined whether congruence or similarity in intrusion about illness, but not avoidance, would be associated with less negative affect as this response to cancer could potentially facilitate adjustment. Fifty-nine husbands and wives completed measures of intrusion and avoidance after the diagnosis of prostate cancer and reported on their daily negative affect for 14 days. Using the actor-partner interdependence model, both patients and their wives who had high levels of intrusive thoughts experienced less negative affect when the other member of the couple also experienced high levels of intrusive thoughts. Those who had higher levels of avoidance had spouses who had higher levels of negative affect regardless of their own levels of avoidance. Congruence in responses to cancer may be adaptive for intrusion but not avoidance because the use of intrusive thoughts by both husbands and wives can allow couples to process the diagnosis of cancer, facilitating psychological adjustment, whereas avoidance does not. The current investigation adds to our understanding of how people within a marital dyad affect each other as they adjust to a cancer diagnosis.     

The impact of disclosure of HIV on the index patient's self-defined family

For most people facing a serious illness, the family is regarded as the primary source of support. Research suggests that patterns of support may differ for people infected with HIV. Access to support normally requires disclosure of one's health problem to others. This study examined the impact of disclosure of HIV on the index patient's self-defined family. Most participants were gay men attending a London HIV clinic. Both they and the care-givers whom they identified to the researchers were interviewed. The results of this qualitative study highlight the fact that many gay men with HIV do not regard their biological family as their primary social support system. Friends and partners were commonly cited as primary care-givers. Most of those interviewed who provided support to the infected individual clearly remembered the disclosure event. They also had a number of emotional reactions, over time, to disclosure. We argue that adjustment to illness among care-givers is a complex two-way, reciprocal process whereby the infected individual and care-giver take subtle cues from one another in terms of how they appear to one another to cope. Some emotionally painful feelings may be experienced but not openly expressed. Therapists who work with families affected by illness should first learn from the patient who he or she defines as 'family'. They should also enquire about the impact of disclosure of illness on all care-givers as well as subsequent reactions and unexpressed feelings associated with this.     

Does How I Feel About It Matter? The Role of Affect in Cognitive and Behavioral Reactions to an Illness Diagnosis

Individuals often have low rates of compliance with treatment recommendations. We examined the role that experienced affect at the time of illness diagnosis might play in influencing thoughts and feelings relating treatment compliance. Participants were randomly assigned to receive a positive, neutral, or negative affect induction after imagining they were diagnosed with kidney cancer. They then reported on thoughts and feelings about the illness and the treatment regimen. Participants also reported interest in additional information about the illness and behavioral intentions for complying with the treatment regimen. Affect significantly influenced interest in information and behavioral intentions. Both effects were mediated by the influence of affect on participants' self-efficacy beliefs. These mediational findings support a mood-as-resource interpretation of the role of affect in treatment compliance.     

Expressive disclosure to improve well-being in patients with amyotrophic lateral sclerosis: A randomised,controlled trial

Amyotrophic lateral sclerosis (ALS) is a terminal neurological disease associated with progressive paralysis, loss of communicative ability and functional decline. Expressive disclosure may help people with ALS, particularly those who are emotionally or socially inhibited, meet psychological challenges associated with the disease. People with ALS (N?=?48) were randomised to expressive disclosure about their disease or no disclosure. Psychological well-being (affect, depression and quality of life) was assessed pre-intervention and also three and six months later. Results of multi-level models indicated that the group that disclosed thoughts and feelings about ALS had higher well-being than the control group at three months post-intervention, but not six months. Ambivalence over emotional expression (AEE) moderated three-month post-intervention well-being. Those low in AEE had higher well-being than those high in AEE regardless of condition. Those high in AEE, who disclosed, had increased well-being from pre-intervention, whereas controls had decreased well-being from pre-intervention. Expressive disclosure may be helpful for people with ALS, but only those who have difficulty expressing emotions. In addition, the intervention had only temporary effects; the dynamic challenges of ALS progression may mean that the effect of processing thoughts and feelings about the disease in one stage may not generalise to later stages.     

Virtual voices: social support and stigma in postnatal mental illness Internet forums

Many women with postnatal mental illness do not get the treatment they need and this is often because stigma prevents disclosure. The purpose of this study was to explore online social support for postnatal mental illness, how women experience stigma and potential disadvantages of using Internet forums. Interviews were conducted with fifteen participants who had suffered postnatal mental illness and had used forums. Systematic thematic analysis identified common themes in relation to social support, stigma and disadvantages of using forums. Most women felt they benefited from visiting forums by developing a shared understanding and discourse about their illness. Findings suggest future research should investigate if women benefit from using online social support provided by forums, if use challenges stigma and further explore potential concerns about using forums.     

Predicting frequency,intensity and duration of other people's self-reported depression

Ss indicated on 5-point qualitative scales how often they felt depressed, how depressed they usually feel. and for how long their feelings of depression usually last and estimated what proportion of the group would choose each scale point. Parallel questions concerning the hypothetical ‘average person’ were included along with these ‘self’ items. The observed and mean estimated percentages of the group using the scale points were compared. The mean predictions were remarkably close to the observed values for all questions, suggesting that people possess higher-order cognitions about the intensity and duration of feelings of depression as well as about frequency. The possible social significance and functions of these sorts of cognitions are discussed in relation to recent studies of illness behaviour.     

Solving the (Real) Other Minds Problem

People care about others’ thoughts, feelings, and intentions but can have considerable difficulty reading others’ minds accurately. Recent advances in understanding how people make such inferences provide significant insight into when people are likely to be reasonably accurate mind readers and when they are not. People tend to reason about others’ mental states by starting with their own and only subsequently adjusting that egocentric default to accommodate differences between themselves and others. Such adjustments tend to be insufficient, rendering final estimates egocentrically biased. When more information about others is available, people tend to rely on existing stereotypes or other expectations to intuit others’ mental states. Systematic errors resulting either from excessive egocentrism or inaccurate expectations can lead to miscommunication, misunderstanding, and social conflict, but these biases also suggest useful strategies for improving mind reading in everyday life.     

The role of objective versus perceived life threat in the psychological adjustment to cancer

Several studies in the oncology literature have used disease stage as a measure of life threat. According to the transactional model of stress (Lazarus and Folkman, ), however, the individual's perception of a threatening situation is more strongly related to distress than the objective event itself. Thus, the present study examined whether cancer patients’ perceived life threat (PLT) is more strongly associated with psychological adjustment than a more objective index of disease prognosis (i.e., cancer stage). In addition, based on cognitive processing theories, this study examined whether intrusive thoughts and avoidance, cognitive characteristics of posttraumatic stress disorder (PTSD), mediate the relationship between PLT and distress. Patients diagnosed with various types of cancer (N = 97) completed questionnaires assessing PLT, cancer-related intrusive thoughts and avoidance, distress, and quality of life. Consistent with theoretical predictions, regression analyses showed that PLT, but not disease stage, was significantly related to psychological distress and quality of life. In addition, intrusive thoughts and avoidance mediated the relationship between PLT and distress. Taken together, these findings suggest that cancer patients’ PLT is more strongly related to distress than is cancer stage and that this association is partly due to cognitive symptoms that are part of PTSD symptomatology. Thus, patients who appraise their illness as life threatening may benefit from cognitive interventions aimed at reducing distress associated with intrusive thoughts.     

A cross-cultural investigation of the communication of suicidal intent in Swedish and Turkish adolescents

A recent study found that Swedish adolescents were more disapproving of a suicidal disclosure by a fictional friend than their Turkish counterparts. Given this finding, the present study investigated whether or not more adolescents in Turkey than in Sweden disclose their own suicidal thoughts to someone, to whom adolescents disclose their suicidal thoughts, what reactions such disclosures produce, and reasons for not disclosing suicidal feelings among 966 Swedish and 956 Turkish high school students. A questionnaire was used to collect information about different aspects of suicidal disclosures. More Turkish than Swedish adolescent suicide ideators disclosed their thoughts. More Turkish than Swedish students believed also that young people thinking about and planning suicide tell others of their plans and thereby ask for help. An overwhelming majority of adolescents in both groups revealed their thoughts to peers. The social reactions to suicidal disclosures in both samples were mainly positive. The two most common reasons for not disclosing in both groups involved interpersonal hopelessness. Adolescents who disclosed their past suicidal thoughts to someone reported having lower current suicidal ideation than those who had not. In line with favorable social attitudes towards suicidal disclosures and lower suicidal mortality rates in Turkey compared with Sweden, more Turkish than Swedish adolescents reported having disclosed their own suicidal thoughts to someone in their social milieu.     

Spontaneous counterfactual thoughts and causal explanations

We report two Experiments to compare counterfactual thoughts about how an outcome could have been different and causal explanations about why the outcome occurred. Experiment 1 showed that people generate counterfactual thoughts more often about controllable than uncontrollable events, whereas they generate causal explanations more often about unexpected than expected events. Counterfactual thoughts focus on specific factors, whereas causal explanations focus on both general and specific factors. Experiment 2 showed that in their spontaneous counterfactual thoughts, people focus on normal events just as often as exceptional events, unlike in directed counterfactual thoughts. The findings are consistent with the suggestion that counterfactual thoughts tend to focus on how a specific unwanted outcome could have been prevented, whereas causal explanations tend to provide more general causal information that enables future understanding, prediction, and intervention in a wide range of situations.     

When Do I Disclose?

SUMMARY

The Americans with Disabilities Act of 1990 (ADA) heralded a new era of civil rights for the disabled, including the mentally ill. This article concerns Title I of the ADA, protections against discrimination in employment. It is a revised version of an article orginally published in a consumer publication, the MDSG/New York Newsletter (Mood Disorder Support Group) to provide guidance on the pro's and con's of making disclosure of mental illness in the job environment. As such it is a valuable reference for both therapists and service recipients who wish to learn more about how the ADA relates to the employment of people with mental illness and who may be faced with the difficult decision of whether or not they should disclose their condition and request reasonable accommodation. Occupational therapists should be well-informed on this topic, to assist consumers with questions on disclosure, reasonable accommodations and other aspects of Title T. Employers can benefit by providing them with information about appropriate accommodations. And occupational therapists can advise both consumers and employers on how a psychiatric illness may affect work performance.     

They heard a cry: psychosocial resources moderate perception of others' distress

Two studies tested whether psychosocial resources affect perception of another's distress. Participants' had their resources depleted, left unchanged, or boosted by elaborately recalling either someone who had betrayed them, a neutral person, or a close and trusted other, respectively. Participants then listened to disturbing baby cries, and rated how much distress the cries conveyed. As predicted, participants who recalled a betrayal subsequently heard the cries as conveying more distress than did other participants (Study 1). However, recalling a betrayal did not amplify cry ratings if, prior to cry rating, betrayal‐related thoughts and feelings were disclosed (Study 2). The moderating effect of disclosure on cry ratings indicates that boosting resources (disclosure) can counteract the effects of resource depletion (betrayal). Results in both studies remained significant even after controlling for mood. This research is the first to show that social contexts, and emotional disclosure, each affects perception of others' distress. Copyright © 2007 John Wiley & Sons, Ltd.     

Stigma, social risk, and health policy: public attitudes toward HIV surveillance policies and the social construction of illness.

Data from a 1999 national telephone survey with a probability sample of English-speaking US adults (N=1,335) were used to assess how support for HIV surveillance policies is related to AIDS stigma and negative attitudes toward groups disproportionately affected by the epidemic. Anonymous reporting of HIV results to the government was supported by a margin of approximately 2-to-l, but name-based reporting was opposed 3-to-l. Compared with other respondents, supporters of name-based surveillance expressed significantly more negative feelings toward people with AIDS, gay men, lesbians, and injecting drug users. More than one third of all respondents reported that concerns about AIDS stigma would affect their own decision to be tested for HIV in the future. Implications for understanding the social construction of illness and for implementing effective HIV surveillance programs are discussed.     

The impact of social constraints on adjustment following a romantic breakup

Following a romantic breakup, people often seek opportunities to talk with close others. Although talking with others may prove helpful for some, the social‐cognitive processing (SCP) model posits that interpersonal interactions can hinder adjustment if disclosers perceive social constraints. The current research marked the first time the SCP model was explored with regard to the dissolution of romantic relationships (N = 217). Consistent with the SCP model, social constraints were associated with greater psychological distress, and avoidance of dissolution‐related thoughts and discussion partially mediated the relation between social constraints and psychological distress as levels of social support decreased. Social support may provide a buffer against engaging in avoidance behaviors in response to feeling socially constrained.     

Written emotional disclosure buffers the effects of social constraints on distress among cancer patients.

The aims of the present study were to examine whether written emotional disclosure would reduce distress among cancer patients and whether it would buffer the effects of high levels of social constraint (negative social responses to patients' expressions of emotion regarding their cancer) on distress. Cancer patients (N=104) were randomly assigned to write about their emotions regarding their cancer 20 min a day for 3 days or to write about a nonemotional topic. They completed questionnaires at baseline and 6 months postintervention. Results showed that written disclosure buffered the effects of social constraints on stress at the 6-month follow-up and that avoidance partly mediated these effects. The present data reinforce the notion that interventions should be tailored to patients' needs.     

Inferences about interdependence shape cooperation

During social interactions in daily life, people possess imperfect knowledge of their interdependence (i.e., how behaviors affect each person’s outcomes), and what people infer about their interdependence can shape their behaviors. We review theory and research that suggests people can infer their interdependence with others along several dimensions, including mutual dependence, power, and corresponding-versus-conflicting interests. We discuss how perceptions of interdependence affect how people cooperate and punish others’ defection in everyday life. We propose that people understand their interdependence with others through knowledge of the action space, cues during social interactions (e.g., partner behaviors), and priors based on experience. Finally, we describe how learning interdependence could occur through domain-specific and domain-general mechanisms.     

The Psychology of Future-Oriented Thinking: From Achievement to Proactive Coping,Adaptation, and Aging

Contributions to this special issue examine multiple aspects of how people think about and prepare for desired and undesired future outcomes, including the processes that link thoughts about one's present situation to possible future outcomes and those that promote the balanced pursuit of long-term vs. short-term goals. They also identify new distinctions among widely studied future-oriented thoughts and feelings (e.g., optimism versus hope). Several contributions examine proactive efforts to prevent adverse effects or reduce their impact in such challenging contexts as being discriminated against, aging and becoming disabled, preparing for potential disasters, or coping with terrorist attacks. Two final contributions examine the implications of temporal factors for advance decision-making in medicine and business. This introductory article highlights the central issues addressed by the contributions and discusses ways in which studying future-oriented thoughts, feelings, and behavior in the contexts of stress and lifespan development may extend our understanding of future-oriented phenomena beyond the achievement domain.     

Social Support,Self-image,and Future Outlook Among Poverty-stricken Unemployed Men in Namibia: A Phenomenological Study

The study aimed to explore how poverty-stricken job seekers in Namibia felt about their unemployment situation and how they perceived themselves, their social support, and their future. Ten men (aged 18 to 40 years) participated in the study. In-depth interviews were conducted and analysed through Interpretative Phenomenological Analysis. The findings revealed that the lack of a job and the constant shortage of food caused feelings of helplessness, nagging thoughts, and difficulties to sleep. All participants received very little social support from family and friends, which they attributed to their joblessness; they perceived their position within their social network as low and degrading. The participants' self-image was negatively inclined and dominated by their unemployment status. Their future outlook concentrated on finding a job but was overshadowed by worries and doubts.     

"IF Only I Were Thin Like Her, Maybe I Could be Happy Like Her": The Self-Implications of Associating a Thin Female Ideal with Life Success

Women often feel dissatisfied with their appearance after comparing themselves to other females who epitomize the thin-ideal standard of beauty. The current study posits that women associate a thin-ideal female body type with positive life-success, and that it may be this psychological link that drives feelings of negativity toward the self after such upward social comparisons. The results revealed that women reported more self-dissatisfaction and less optimism about their possible future life outcomes after exposure to a thin-ideal female target that ostensibly had a successful life than when the target ostensibly had an unsuccessful life.