Psychological intervention with couples coping with breast cancer: A systematic review

Objective: Information about psychological intervention with couples coping with breast cancer is not well-disseminated. This can be explained, at least in part, by the absence of knowledge about the efficacy of this kind of intervention. The aim of the present systematic review is to identify and describe psychological interventions for couples coping with breast cancer and evaluate their efficacy.

Design: Studies identified by a searching multiple literature databases related to health and psychology between 1975 and 2013. Rigorous inclusion and exclusion criteria were utilised.

Results: Of 129 abstracts, 13 were extracted for further analysis and a final ten studies were deemed eligible for inclusion. Data were extracted from each study regarding study sample characteristics, design, results and methodological limitations. The results obtained were mixed in regard to efficacy, although the overwhelming majority of studies (eight studies) found benefits for both women and their partners in some dimensions, such as quality of life, psychological distress, relationship functioning and physical symptoms associated with cancer.

Conclusion: Psychological interventions for couples coping with breast cancer appear to be effective for both women and their partners. However, further studies are needed to evaluate the efficacy of couple-based interventions and, to identify for whom and how they are more effective.     

Adolescent coping scales: a critical psychometric review

Individual coping is identified as an important factor in relation to health and well-being. Although several coping scales have been developed, key terms of coping such as nature and a number of primary and secondary factors (dimensions) are obscure. Coping scales, such as those that have been developed through exploratory factor analysis (EFA), have been criticized for poor psychometric properties, yet the critique so far does not evaluate development of the scales against best test-theoretical practice. The present study reviews six adolescent coping scales against ten detailed psychometric criteria in relation to statistical choices throughout the process of scale development. All six scales measured poorly on several criteria. Best practice had not been followed throughout their development and they suffered serious psychometric limitations. These findings indicate that there still is empirical research to be pursued in search of latent constructs and possible dimensions of coping through the implementation of EFA.     

Coping with coping assessment: A critical review

The recent literature on self-report measures of coping reactions and strategies is reviewed and critically evaluated. Most of the coping research has focused on assessing several basic coping behaviours or reactions. These include dimensions such as task-oriented coping, emotion-oriented coping, and avoidance-oriented coping. In general, most of the coping scales that have been developed have a variety of psychometric inadequacies. This state of affairs has created at least two major problems in the coping literature: (1) The proliferation of problematic coping scales, sometimes measuring different constructs, makes it difficult to generalize from one population and/or one health problem to another. (2) Since psychometrically sound instruments are a precondition for studying the relationships among coping, personality, and health, scales with psychometric problems preclude obtaining valid and generalizable information about coping behaviour. Methodological problems in the area have seriously restricted the development of a systematic body of theory and empirical knowledge about coping.     

Collaborative coping and daily mood in couples dealing with prostate cancer

Collaborative coping (i.e., spouses pooling resources and problem solving jointly) may be associated with better daily mood because of heightened perceptions of efficacy in coping with stressful events. The study examined the daily processes of collaborative coping (individuals' perceptions that the spouse collaborated), perceived coping effectiveness (ratings of how well they dealt with the event), and mood (i.e., Positive and Negative Affect Scale) across 14 days in 57 older couples coping with stressors involving the husband's prostate cancer and daily life in general. In hierarchical multivariate linear models, collaborative coping was associated with more positive same-day mood for both husbands and wives and less negative mood for wives only. These associations were partially mediated by heightened perceptions of coping effectiveness. Exploratory analyses revealed that collaborative coping was more frequent among wives who performed more poorly on cognitive tests and couples who reported greater marital satisfaction and more frequently using collaboration to make decisions. The results suggest that older couples may benefit from collaborative coping in dealing with problems surrounding illness.     

Protective buffering and psychological distress among couples coping with breast cancer: The moderating role of relationship satisfaction.

This study examined whether the association between protective buffering and psychological distress was moderated by relationship satisfaction. Protective buffering is defined as hiding worries, denying concerns, and yielding to one's partner in an effort to avoid disagreement and reduce one's partner's upset and burden. Two hundred thirty-five women diagnosed with early stage breast cancer and their partners completed measures of protective buffering, psychological distress, and relationship satisfaction at 3 time points over an 18-month period after cancer diagnosis. The authors hypothesized that protective buffering would result in more distress among patients and partners reporting higher relationship satisfaction than among patients and partners reporting lower levels of relationship satisfaction. Patients' protective buffering predicted more distress among patients rating their relationships as more satisfactory, whereas the patients' buffering did not predict distress among patients rating their relationships as less satisfactory. Partner relationship satisfaction also moderated the association between patients' buffering and partners' distress. These findings elucidate conditions under which protective buffering may have detrimental effects.     

Emotional congruence in older couples coping with wives' osteoarthritis: exacerbating effects of pain behavior

The authors examined congruence in the negative emotions (depression, anger) of 101 female osteoarthritis patients (M age = 69 years) and their caregiving husbands (M age = 71 years) and the extent to which patients' pain behavior (e.g., limping, rubbing joints) exacerbated linkages between partners' negative emotions. Associations between patients' and husbands' emotions were examined within domains (e.g., depression-depression) and across domains (e.g., depression-anger) over a 6-month interval. Regression analyses revealed that patients' initial levels of depressive symptoms and anger were related to increases in their husbands' anger over time. The associations between patients' depressive symptoms and their husbands' depressive symptoms and anger were conditioned by pain behaviors. Patients who were more depressed and who engaged in high levels of pain behavior had husbands who became more depressed and angry.     

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.     

Caregiving styles and anxiety among couples: coping versus not coping with cardiac illness

Background and Objectives: partners’ caregiving efforts are not always beneficial to both recipient and provider. Bowlby’s conceptualization of caregiving style as a stable predisposition may clarify such caregiving effects. The relationship between caregiving style (compulsive and sensitive) and anxiety among couples coping with cardiac illness and a matching control group not coping with cardiac illness were assessed. We hypothesized that one’s compulsive caregiving would associate positively, and one’s sensitive caregiving would associate negatively, with one’s and one’s partner’s anxiety across contexts (cardiac and non-cardiac) and gender. Design: A comparative design of 131 couples with a diagnosis of husbands’ acute cardiac syndrome and 68 matched couples in the community was applied. Methods: The Adult Caregiving Questionnaire and the Brief Symptoms Inventory were administered. Results: Structural equation modeling revealed that one’s compulsive caregiving was positively associated with one’s anxiety, across most contexts. Multi-group analyses revealed that the associations between one’s compulsive caregiving and one’s partner’s anxiety levels differed depending on gender and context. Conclusions: The distress which emerges in an individual who takes on a caregiving role and in his/her partner seems to result not only from the demands of the concrete caregiving situation but also from one’s and one’s partner’s developmental history.     

Relations between personality and coping: a meta-analysis

Personality may directly facilitate or constrain coping, but relations of personality to coping have been inconsistent across studies, suggesting a need for greater attention to methods and samples. This meta-analysis tested moderators of relations between Big Five personality traits and coping using 2,653 effect sizes drawn from 165 samples and 33,094 participants. Personality was weakly related to broad coping (e.g., Engagement or Disengagement), but all 5 traits predicted specific strategies. Extraversion and Conscientiousness predicted more problem-solving and cognitive restructuring, Neuroticism less. Neuroticism predicted problematic strategies like wishful thinking, withdrawal, and emotion-focused coping but, like Extraversion, also predicted support seeking. Personality more strongly predicted coping in young samples, stressed samples, and samples reporting dispositional rather than situation-specific coping. Daily versus retrospective coping reports and self-selected versus researcher-selected stressors also moderated relations between personality and coping. Cross-cultural differences were present, and ethnically diverse samples showed more protective effects of personality. Richer understanding of the role of personality in the coping process requires assessment of personality facets and specific coping strategies, use of laboratory and daily report studies, and multivariate analyses.     

The role of religious values in coping with cancer

The relationship between transcendent meaning attribution, religious orientation, and psychological well-being was studied in cancer and noncancer patients to test the hypotheses that intrinsic religious values and life meaning enhance coping and well-being during the course of the life-threatening illness. Subjects were 44 patients receiving medical treatment for cancer and noncancer medical conditions. In the cancer group, higher levels of attributed life meaning were positively linked with intrinsic religious orientation, and associated with lower levels of despiar, anger-hostility, and social isolation. Cancer patients scored higher than noncancer patients on depersonalization, suggesting the presence of psychic numbing in response to their illness. Noncancer group results were characterized by positive correlations between the two groups in coping styles and salience of life meaning attribution. A rationale for the observed differences in coping styles between the two groups is presented, highlighting perceived life threat as a key differentiating variable.     

The role of religion in coping with childhood cancer

The role of religion in the crisis of childhood cancer was explored through interviews with 265 members of 118 families that had a child with cancer. Measures of family and patient religiosity were related to a broad spectrum of parental and patient perceptions and activities. Evidence was obtained that the religion related positively to familial support of the patient and efforts to keep school performance at pre-illness levels. There were signs of a narrowing of the family's social field while relationships with close friends were strengthened. Religion appeared to act as a protective-defensive system that motivated efforts by family members to cope constructively with the crisis of illness.This work is based on data from National Cancer Institute Project 212-46-1061, principal investigator, William J. Zwartjes, M.D.     

The nature and dimensionality of organizational citizenship behavior: a critical review and meta-analysis

This article reviews the literature on organizational citizenship behavior (OCB) and its dimensions as proposed by D. W. Organ (1988) and other scholars. Although it is assumed that the behavioral dimensions of OCB are distinct from one another, past research has not assessed this assumption beyond factor analysis. Using meta-analysis, the authors demonstrate that there are strong relationships among most of the dimensions and that the dimensions have equivalent relationships with the predictors (job satisfaction, organizational commitment, fairness, trait conscientiousness, and leader support) most often considered by OCB scholars. Implications of these results are discussed with respect to how the OCB construct should be conceptualized and measured in the future.     

Gender: A critical factor in a couples group

Couples group therapy should be considered as a primary treatment for marital couples whose dysfunctional interaction is rigidified and chronic. A gender-linked perspective for treatment is developed which expands a psychodynamic approach underscoring power as one of the central issues in marital conflict. Clinical vignettes from couples groups illustrate this model. A gender orientation facilitates the psychodynamic group process, decreases unrealistic expectations of the spouse, and encourages greater acceptance of male/female and individual differences. In this setting, individuals are able to develop new and more functional modes of interaction with their spouses, which generate an increased sense of empowerment.Excerpts from this paper were presented at the American Family Therapy Association meeting in Montreal, 1988.The authors gratefully acknowledge the helpful comments of Henry Grunebaum, M.D., and Fred Sander, M.D.     

Functional neuroimaging studies of category specificity in object recognition: a critical review and meta-analysis

Functional neuroimaging studies in which the cortical organization for semantic knowledge has been addressed have revealed interesting dissociations in the recognition of different object categories, such as faces, natural objects, and manufactured objects. The present paper critically reviews these studies and performs a meta-analysis of stereotactic coordinates to determine whether category membership predicts patterns of brain activation across different studies. This meta-analysis revealed that, in the ventral temporal cortex, recognition of manufactured objects activates more medial aspects of the fusiform gyrus, as compared with natural object or face recognition. Face recognition activates more inferior aspects of the ventral temporal cortex, as compared with manufactured object recognition. The recognition task used—viewing, matching, or naming—also predicted brain activation patterns. Specifically, matching tasks recruit more inferior occipital regions than do either naming or viewing tasks, whereas naming tasks recruit more anterior ventral temporal sites than do either viewing or matching tasks. These findings indicate that the cognitive demands of a particular recognition task are as predictive of cortical activation patterns as is category membership.     

Predictors of relationship adjustment among couples coping with a high risk of developing breast/ovarian cancer

This study investigated the association between supportive and collaborative processes and dyadic adjustment in 94 women at increased risk of breast/ovarian cancer and their partners. Participants were recruited through two familial cancer clinics. They completed mailed, self-report questionnaires that included measures of psychological distress, dyadic adjustment (consensus, cohesion and satisfaction) and couple predictor variables (perceived support and team approach). Most couples reported average-to-high levels of consensus, cohesion and satisfaction, with a small proportion of couples (6.4%) reporting scores that reached clinically significant levels of dyadic distress. Greater perceived support was associated with better dyadic consensus and satisfaction, and dyadic cohesion and satisfaction were higher among couples who reported greater use of a team approach. General distress did not moderate the association between dyadic coping and relationship quality. There were no significant relationships between intra-couple congruence on support or team approach, and dyadic adjustment. Most couples had a functional relationship in the face of the current health stressor, although a subgroup may be at elevated risk of negative psychological consequences, including further relationship strain. The results highlight that dyadic coping strategies are important factors involved in the quality of couples' relationship following genetic counselling for breast/ovarian cancer risk.     

Children's coping with peer rejection: the role of depressive symptoms,social competence,and gender

The present study investigated children's anticipated emotional response and anticipated coping in response to peer rejection, as well as the qualifying effects of gender, depressive symptoms, and perceived social competence. Participants (N = 234), ranging in age between 10 and 13 years, were presented with two written vignettes depicting peer rejection. The most highly endorsed coping strategies were behavioural distraction, problem‐focused behaviour, and positive reappraisal. Results indicate that children higher in depressive symptoms reported a more negative anticipated mood impact. Moreover, children higher in depressive symptoms were less inclined to endorse behavioural and cognitive coping strategies typically associated with mood improvement (e.g., behavioural distraction, positive reappraisal). Independent of depression, children scoring higher on perceived social competence reported more active, problem‐oriented coping behaviour in response to the stressors. Types of coping were largely unaffected by gender, however girls reported higher levels of anticipated sadness than boys in response to the rejection vignettes. Theoretical and clinical implications are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

Moderating effects of age and context on the relationship between gender,sex role differences,and coping

We examined age, gender, sex role, and context differences in type of coping among adolescents through older adults. They were given measures of coping and sex role orientation for both relationship and achievement contexts. Emotion-focused coping decreased with age, with high-femininity individuals reporting higher levels of coping. Older low-feminine adults reported greater use of emotion-focused coping than all other subjects except adolescents. Problem-focused coping showed an upward trend with age for low-feminine subjects. High-feminine subjects followed a similar trend until adulthood and then showed a decrease. Achievement and relationship contexts moderated the relationship between age, gender, sex role orientation, and problem-focused coping. Results are discussed in terms of sex roles and adult development.     

New trends in gender and mathematics performance: a meta-analysis

In this article, we use meta-analysis to analyze gender differences in recent studies of mathematics performance. First, we meta-analyzed data from 242 studies published between 1990 and 2007, representing the testing of 1,286,350 people. Overall, d = 0.05, indicating no gender difference, and variance ratio = 1.08, indicating nearly equal male and female variances. Second, we analyzed data from large data sets based on probability sampling of U.S. adolescents over the past 20 years: the National Longitudinal Surveys of Youth, the National Education Longitudinal Study of 1988, the Longitudinal Study of American Youth, and the National Assessment of Educational Progress. Effect sizes for the gender difference ranged between -0.15 and +0.22. Variance ratios ranged from 0.88 to 1.34. Taken together, these findings support the view that males and females perform similarly in mathematics.