Patient and Partner Quality of Life and Psychosocial Adjustment Following Radical Prostatectomy

We prospectively examined differences in quality of life and psychosocial adjustment in 80 prostate cancer patients and their partners (n = 65) beginning before radical prostatectomy and proceeding across the first year postsurgery. Both members of the couple experienced significant changes associated with the patient's cancer, however their experiences differed in some regards. Patients experienced reprieve from emotional distress and negative affect immediately following surgery despite worsened physical functioning. Partner quality of life and psychosocial adjustment scores were generally more constant from presurgery to postsurgery, with improvements noted 1 year later. For both patients and partners, cancer-specific stress symptoms declined progressively over the year. We also obtained partial support for the effectiveness of a single-session communication intervention on patient social/family wellbeing and partner general stress. Findings have implications for patient and partner adjustment following radical prostatectomy, and attest to the importance of incorporating partner evaluations into psychosocial oncology research.     

Different Perspectives Regarding Quality of Life in Chronically ill and Healthy Individuals

The areas that were suggested as most important with regard to Quality of Life (QoL) were examined in groups of individuals who were healthy, and those with a chronic condition. An electronic survey was completed by 892 participants (261 healthy and 631 with a chronic condition). They answered three questions relating to QoL: what is most important to you; what areas most impact your QoL; and an open question what does QoL mean to you. Across the three questions both groups highlighted physical functioning, independence and mobility as key areas for QoL. However, the group with a chronic condition tended to find issues of functioning such as pain, fatigue, and sleep as more important to their QoL than the healthy participants. In contrast, the healthy participants tended to note the importance of relationships and family as more important than the group with a chronic condition. That there were such differences between the groups might suggest that different aspects of QoL could be rated as more important when examining this issue with samples with a chronic condition and those without such a condition.     

Sexual Attitudes of Males and Females as Predictors of Interpersonal Attraction and Marital Compatibility1

Two investigations examine the effect of similarity of sexual attitudes on (a) attraction to a stranger and (b) marital sexual satisfaction. In an experiment using undergraduates, manipulation of subject-stranger similarity in general affective orientation to sexuality affected attraction and other evaluative dependent variables. In the second investigation, married couples revealed sexual attitudes and sexual satisfaction. Husbands and wives were similar (r= 0.58, p < 0.001) in their affective orientations to sexuality. Discrepancy between the partners’ scores predicted sexual dissatisfaction in both partners. In addition, the wife's affective orientation to sexuality predicted more indices of sexual satisfaction and adjustment in both the wife and the husband than did the husband's affective orientation to sexuality. Finally, spouses with a positive affective orientation to sexuality were more accurate when judging their partner's sexual enjoyment, compared to spouses with a negative orientation. The findings have implications for the effects of similarity of attitudes on interpersonal attraction and on relationship quality.     

The association between self-consciousness about appearance and psychological adjustment among newly diagnosed breast cancer patients and survivors: the moderating role of appearance investment

This study examined the moderating role of two facets of appearance investment (self-evaluative salience (SES) and motivational salience (MS)) in the relationship between self-consciousness about appearance and psychological adjustment (depression, anxiety and psychological quality of life (QoL)) in a sample of 134 breast cancer patients (68 newly diagnosed patients and 66 survivors). No significant differences were found between groups on body image variables. Among survivors, the associations between self-consciousness about appearance and the outcome variables were only significant at high (depression, psychological QoL) levels and at moderate (psychological QoL) levels of SES. Self-consciousness about appearance contributed to poor adjustment in both groups. This study demonstrates that appearance investment plays a key role in patients' adjustment and highlights the SES-MS distinction. SES seems to be a vulnerability factor for poor adjustment, and MS seems to be a protective factor that helps women cope with changes in appearance.     

An interpersonal perspective on depression: the role of marital adjustment, conflict communication, attributions, and attachment within a clinical sample

Previous studies have focused on the difficulties in psychosocial functioning in depressed persons, underscoring the distress experienced by both spouses. We selected conflict communication, attribution, and attachment as important domains of depression in the context of marital adjustment, and we analyzed two hypotheses in one single study. First, we analyzed whether a clinical sample of couples with a depressed patient would differ significantly from a control group on these variables. Second, we explored to what degree these variables mediate/moderate the relationship between depressive symptoms and marital adjustment. The perspectives of both spouses were taken into account, as well as gender differences. In total, 69 clinical and 69 control couples were recruited, and a series of multivariate analyses of variance and regression analyses were conducted to test both hypotheses. Results indicated that both patients and their partners reported less marital adjustment associated with more negative perceptions on conflict communication, causal attributions, and insecure attachment. In addition, conflict communication and causal attributions were significant mediators of the association between depressive symptoms and marital adjustment for both depressed men and women, and causal attributions also moderated this link. Ambivalent attachment was a significant mediator only for the female identified patients. Several sex differences and clinical implications are discussed.     

Family functioning and the social adaptation of hearing-impaired youths

This study examined the associations between important aspects of family functioning and the adjustment of hearing-impaired youths. Participants were 75 hearing-impaired youths and their hearing parents. The dependent variables were mothers' and fathers' ratings of child behavior problems and social competence. Independent variables included parental symptomatology, parental ratings of family stress, and family members' perceptions of family cohesion and family adaptability. Demographic characteristics and the youth's degree of hearing loss and mode of communication were used as control variables. Results from multiple regression analyses showed that parental ratings of the youths' behavior problems were linked with parental symptomatology, and that maternal ratings of the youths' behavior problems were associated with low family adaptability. Parental ratings of the youths' social competence were predicted by family stress. Overall, key aspects of family functioning accounted for considerably more variance than did the control variables. The methodological and conceptual implications of the findings are discussed.     

Quality of life in breast cancer patients: Associations with optimism and social supportCalidad de vida en pacientes con cáncer de mama: asociación con optimismo y apoyo social

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.     

Quality-of-life after penile prosthesis placed at radical prostatectomy

Abstract

The clinical and psychosocial effects of immediate penile prosthesis implantation at the time of radical prostatectomy (RP) were investigated in 97 consecutive patients and 68 partners. Prosthesis recipients reported more frequent sexual contact, fewer marital problems and slightly fewer sexual functioning problems than the RP-alone patients. There were no group differences on any sociodemographic characteristics, on disease recurrence, on physical and psychosocial functioning, or on reported depression. Patients who chose the prosthesis did, however, evidence less of a link between depression and functional limitations and between depression and marital problems. They also had lower levels of agreement with their partners in reporting their own depression, as compared to the patients who opted for RP surgery alone. We conclude that the penile prosthesis was associated with an increased frequency of sexual contact, a reduction in reported marital problems, and stylistic differences between the two patient groups in dealing with affect.     

The role of spousal relationships in fibromyalgia patients’ quality of life

Fibromyalgia (FM) is a chronic pain syndrome that includes debilitating symptoms such as widespread pain and tenderness, fatigue, and poor physical functioning. Research has shown FM patients’ choice of coping style and relationship quality with their spouse can impact their mental quality of life (QoL), but no known study has examined the protective nature of relationship quality and coping behaviors on both patient physical and mental QoL in the context of chronic pain. We examined 204 patients with FM on the (a) roles of coping styles and relationship quality on patient quality of life, and (b) moderating effect of relationship quality on the association between negative coping style and patient QoL. A series of multiple regressions found patients’ coping styles were not significantly associated with physical QoL, but were significantly associated with mental QoL. Patients’ relationship quality with their spouse was significantly associated with mental QoL, but not physical QoL and no significant interactions with negative coping style were found. Our results emphasize the importance of coping styles and relationship quality between patients and their spouses in the context of chronic pain. Clinicians can incorporate the patient’s relationship as part of a more holistic approach to care and improving outcomes.     

Children's Adjustment to Parental Physical Illness

We review recent empirical literature examining the impact of parent physical illness on child functioning. We review studies of illness characteristics (n = 16), individual characteristics (n = 6), and family characteristics (n = 6). Although children's self-reports indicate heightened distress, parental reports do not suggest more problematic functioning. Child adjustment appears to be more closely related to perceptions of stressfulness rather than to objective illness severity indices. Adolescent girls seem to represent a group at heightened risk. Preliminary results suggest that family variables such as cohesion, conflict, and individual and family coping styles are important predictors of child adjustment.     

Sense of coherence,resilience, and habitual optimism in cancer patients

Background/ObjectiveThe aim of this study was to investigate whether the three resource variables sense of coherence, resilience, and dispositional optimism become impaired when people are ill with cancer, whether there are sex and age differences in these variables, and how these variables are associated with quality of life (QoL).MethodA sample of 1108 patients with mixed cancer diagnoses were examined using the Sense of Coherence Scale-3 (SOC-3), the Brief Resilience Scale (BRS), the Life Orientation Test (LOT-R), and the QoL questionnaire EORTC QLQ-C30.ResultsThe three resource variables showed somewhat lower levels in the patients’ sample in comparison with general population controls, with effect sizes between ?0.10 and ?0.23. While there were only small sex differences in the resource variables, significant age differences were found in these variables, with stronger detriments in younger patients. The correlations among the resource variables ranged between .53 and .61. Sense of coherence was more strongly correlated with QoL than resilience and optimism.ConclusionsCancer patients with low levels of personal resources adapt to their disease more poorly than patients with high levels. In addition to limitations in QoL, health care professionals should also consider patients’ resources for coping with the disease. Special attention should be given to young cancer patients.     

What Matters for Well-Being: Individual Perceptions of Quality of Life Before and After Important Life Events

In recent decades, what matters for individual quality of life (QoL) has increasingly been the focus of empirical social science research. However, individuals are rarely asked directly what is important for their quality of life as part of large-scale surveys. The present analysis studies perceptions of what matters for QoL in a large-scale longitudinal dataset—the British Household Panel Survey—which includes an open-ended question on QoL in three waves spanning ten years. We find that concepts of QoL change over the life course and differ between men and women. We hypothesize that changes in perceptions of QoL are related to important life events, such as the birth of a first child and retirement. These life events constitute ’turning points’ after which individuals often shift their priorities of what matters for their QoL. We further explore whether such shifts in priorities are stable or disappear more than five years after the life event.     

Is Good Sex Good for You? Rethinking Sexuality and Health

Despite the central importance of sexuality to human well‐being, the study of sexuality remains marginalized within health psychology, which hampers the ability of clinicians and policy‐makers to promote comprehensive health and well‐being. In this review we discuss the evidence that sexual functioning makes critical contributions to human health, focusing specifically on findings linking sexual activity to morbidity and mortality, to the health‐promoting effects of intimate relationships, and to processes of emotion regulation. We argue that researchers studying the psychology of health and well‐being should more substantively integrate sexuality into their research agendas. Health psychologists’ specific expertise in investigating and interpreting complex, reciprocal associations between subjective emotional states, health‐relevant cognitions, and health‐relevant behavior can make a notable contribution to elucidating some of the most intruiging correlations between sexuality and health that have emerged from medical and epidemiological studies. If we want to foster optimum physical and mental health among youths and adults, we must rigorously investigate the multiple mechanisms through which positive sexual functioning plays a unique and fundamental role in human well‐being across the life course.     

Parental conflict and other correlates of the adjustment of school-age children whose parents have separated

In this study, several factors related to psychological adjustment of schoolage children were examined in a sample of 40 lower-class families in which the parents were separated. It was hypothesized that parental conflict and other indices of family adversity, including maternal depression, income, and the length of time past since parental separation, would be important predictors of children's behavioral adjustment. Parental acrimony was found to be a significant correlate of children's behavioral problems, even when other family variables were taken into account. In addition, independent and additive effects on children's functioning were found for parental discord and maternal depression, with some support found for an additional variable, family income. In contrast to some prior investigations, the length of time since parental separation was unrelated to children's functioning. Results are discussed in terms of Rutter's cumulative stress hypothesis and previous research on parental discord.This research was supported in part by a grant to Robert E. Emery from the William T. Grant Foundation.     

Personality and its links to quality of life: Mediating effects of emotion regulation and self-efficacy beliefs

We investigated the relationship between personality and quality of life (QoL) considering emotion regulation and self-efficacy beliefs as mediating factors. A total of 409 participants from the French-speaking regions of Switzerland and from France completed questionnaires on personality, emotion regulation, self-efficacy beliefs, and QoL. Our findings revealed that specific personality traits have significant direct and indirect effects on QoL, mediated by emotion regulation and self-efficacy. Particularly, neuroticism was strongly and negatively related to emotion regulation and QoL, but not significantly linked to self-efficacy, whereas extraversion and conscientiousness were positively associated with all variables. This is the first study to demonstrate that both emotion regulation and self-efficacy are important mechanisms that link specific personality traits to QoL, suggesting that they channel and modulate the personality effects. However, more work is needed to understand these relationships in more detail (e.g., how the personality traits concurrently influence each other as well as emotion regulation and self-efficacy).     

Rorschach assessment of psychological functioning in sexually abused girls

We measured psychological functioning in a group of 79 Black females between the ages of 5 and 16 and a comparison group of nonabused girls using the Rorschach. In addition to Exner's (1985) Comprehensive System, the Elizur (1949) Rorschach Content Test Scale (RCT), the Mutuality of Autonomy Scale (MOA; Urist, 1977; Urist & Shill, 1982), and the Barrier and Penetration Scales (Fisher & Cleveland, 1968) were used. Sexually abused girls were found to show more disturbed thinking, to experience a higher level of stress relative to their adaptive abilities, to describe human relationships more negatively, and to show more preoccupation with sexuality than the comparison group. The distress experienced by the victimized children was more related to internal mediating variables then to abuse characteristics. Sexually abused girls who are cognitively and emotionally active also experienced high levels of distress compared to abused girls who are psychologically constricted.     

Mothers' and Fathers' Psychological Symptoms and Marital Functioning: Examination of Direct and Interactive Links with Child Adjustment

A community sample of 51 mother-father dyads with a school-age child rated marital functioning, parental psychological symptoms, and children's adjustment problems. Parents with more psychological symptoms reported lower marital satisfaction levels. Mothers' and fathers' marital functioning and symptomatology individually related to children's adjustment in the expected directions. In addition, interaction tests revealed that, for mothers but not fathers, the combination of poorer marital functioning and higher levels of psychological symptoms amplified the negative effects on children's adjustment problems. These findings support the hypothesis that parental psychopathology and marital adjustment together affect children's functioning in an interactive way, underscoring the need to consider multiple family influences in studies of child development.     

Rorschach Assessment of Psychological Functioning in Sexually Abused Girls

We measured psychological functioning in a group of 79 Black females between the ages of 5 and 16 and a comparison group of nonabused girls using the Rorschach. In addition to Exner's (1985) Comprehensive System, the Elizur (1949) Rorschach Content Test Scale (RCT), the Mutuality of Autonomy Scale (MOA; Urist, 1977, Urist & Shill, 1982), and the Barrier and Penetration Scales (Fisher & Cleveland, 1968) were used. Sexually abused girls were found to show more disturbed thinking, to experience a higher level of stress relative to their adaptive abilities, to describe human relationships more negatively, and to show more preoccupation with sexuality than the comparison group. The distress experienced by the victimized children was more related to internal mediating variables then to abuse characteristics. Sexually abused girls who are cognitively and emotionally active also experienced high levels of distress compared to abused girls who are psychologically constricted.     

Quality of Life (QoL) in a Brazilian Sample of Older Adults: The Role of Sociodemographic Variables and Depression Symptoms

The aim of the present study was to identify relevant variables associated with Quality of Life (QoL) in older adults. Older adults, up to 60 years old, were interviewed. Subjects were recruited through convenience sampling. 339 paticipants, who were stratified by gender, age, and subjective perception of health and illness, answered questions on sociodemographic issues, QoL (WHOQOL-100) and depressive symptomathology (Beck Depression Inventory—BDI). The multiple linear regression analysis showed associations of overall perception of QoL with depression levels, subjective perception of health status and gender. The individual analysis of each domain concluded that depression levels are correlated to all QoL domains, while health status was associated with physical, psychological, independence level and social relationship domains. Other variables were also assessed. The assessment of older adults concerning their QoL perceptions is associated with gender, age, marital status, social class, literacy rate, perception of health, and more substantially associated with depressive symptoms levels. Nevertheless, some limitations of this study and further ones are suggested.     

Adjustment of Siblings of Children with Mental Health Problems: Behaviour, Self-Concept, Quality of Life and Family Functioning

This study examined the adjustment of siblings of children with mental health problems. The participants had brothers or sisters receiving treatment at a Child and Adolescent Mental Health Service within the Hunter New England Health Service, New South Wales, Australia. Seventy-five siblings completed questionnaires on their self-concept, quality of life and family functioning. Their carers completed questionnaires on the sibling’s behaviours, family demographics and family functioning. The diagnosis and severity of disability of index children were attained from the treating clinician. The study revealed the siblings had significantly higher rates of psychopathology, poorer quality of life and lived in more dysfunctional families than normally developing children. Regression modelling predicted variables related to the three main behaviour scales of the Child Behaviour Checklist (CBCL). Family functioning, family communication and the extreme ends of family cohesion and balance, were the most significant contributors to regression model. The sibling self-concept domains of global self-worth, athletic competence and behavioural conduct, contributed to the model. Additionally, a smaller family size was associated with more internalising behaviour disorders in the siblings. The diagnosis and severity of mental health problem of the index child and other family demographic factors did not impact on the sibling’s behavioural functioning. This study highlights that siblings of children with mental health difficulties are a group vulnerable to adjustment difficulties regardless of the index child’s diagnosis or the severity of impairment. Overall, family functioning had a greater impact on the siblings than other factors.