Meta-analysis of psychosocial interventions on survival time in patients with cancer

Objective: This study was to evaluate the effects of psychosocial interventions on survival in adult patients with cancer.

Method: MEDLINE via PubMed, Cochrane Library CENTRAL, CINAHL, and Korean electronic databases (September 2014) were searched. Methodological quality was assessed using Cochrane’s Risk of Bias for randomized studies. The RevMan 5.3 program of the Cochrane library was used for data analysis.

Results: Fifteen randomized controlled trials met the inclusion criteria, with a total of 2940 participants. Overall, psychosocial interventions was not associated with better survival (HR = .83, 95% CI [.68, 1.10], p = .06, I² = 64%). In subgroup analysis, based on six trials with 1448 subjects, psychoeducational interventions for cancer patients with non-metastatic at intervention implementation resulted in a 41% reduction in the risk of dying of cancer (HR = .59, 95% CI [.49, .71], p < .001, I² = 0%). For psychoeducational intervention, significant survival benefit were found when health staff delivered the intervention and at a follow-up time of more than 10 years.

Conclusions: Use of psychoeducational interventions for cancer patients at early stage appeared to have beneficial effects on survival, preferably for delivering of health staff. However, conduct of further psychosocial studies with adequate power will lead to better understanding of the effects of treatments on survival outcome.     

Observer memories may not be for everyone

ABSTRACT

Six studies explored the preponderance of people who experience third-person perspective observer memories during autobiographical memory retrieval. The concept of first-person field versus observer memories has been extensively used in the areas of cognitive, social, and clinical psychology. An implicit assumption is the idea that most people use both of these perspectives. What varies are the circumstances that bias people to use one perspective over another for a given autobiographical memory. We challenge that assumption across six studies by showing that, while there are some people who report to regularly have observer memories, there are also those that report to rarely or never have them. These reports were found to be related to levels of reported dissociative experiences. We discuss how this difference in the experience of observer memories may also reflect other innate characteristics, and may correspond to predispositions for various pathologies, including depression, social phobia, and post-traumatic stress disorder.     

Animals may not be stuck in time

Humans have the ability to mentally travel forward and back in time. They can retrieve vivid memories of past events (episodic memories) and can imagine the future (planning). Although it has been suggested that this is a uniquely human ability, the evidence for subjective time travel in humans is typically based on verbal report and elaboration. Such evidence cannot be obtained from animals. However, we may have indirect evidence for episodic memory and planning. For example, we can show that animals can ‘report’ about their recent past experience when they are unexpectedly asked to do so—performance that is analogous to episodic memory. We can also show that animals use the anticipation of a future event as the basis for a present action—analogous to planning. Thus, we have suggestive evidence that animals may not be stuck in time.     

Whatever it is better to be than not to be

The Anselmian claim that God is that than which a greater cannot be thought in virtue of being ‘whatever it is better to be than not to be’ may be accused of incoherence or even unintelligibility. By proposing a non-relative but apparently meaningful analysis thereof, I attempt to defend it against such criticism. In particular, I argue that ‘whatever it is better to be than not to be’ can be plausibly interpreted so as to imply very many attributes traditionally predicated of that than which a greater cannot be thought. Central to this line of reasoning is the assumption that whatever is an actual moral being is greater, simpliciter, than whatever is not an actual moral being.     

Faster might not be better: Pictures may not elicit a stronger unconscious priming effect than words when modulated by semantic similarity

It has been suggested that unconscious semantic processing is stimulus-dependent, and that pictures might have privileged access to semantic content. Those findings led to the hypothesis that unconscious semantic priming effect for pictorial stimuli would be stronger as compared to verbal stimuli. This effect was tested on pictures and words by manipulating the semantic similarity between the prime and target stimuli. Participants performed a masked priming categorization task for either words or pictures with three semantic similarity conditions: strongly similar, weakly similar, and non-similar. Significant differences in reaction times were only found between strongly similar and non-similar and between weakly similar and non-similar, for both pictures and words, with faster overall responses for pictures as compared to words. Nevertheless, pictures showed no superior priming effect over words. This could suggest the hypothesis that even though semantic processing is faster for pictures, this does not imply a stronger unconscious priming effect.     

The world may not be just for you but you'd better not say it: On the social value of expressing personal belief in a just world

The expression of personal belief in a just world (PBJW) has been discussed as a criterion of excellence in social judgments. In four experimental studies we hypothesized and found that targets who express high versus low PBJW are judged as more: (i) deserving of success and (ii) suited to socio-organizational expectations. The four studies show that suitability to socio-organizational expectations mediates the relation between PBJW expressed and success deservingness, even after controlling for judgments of likability, status, rationality, optimism, and targets as victims. Studies 2 and 3 show this pattern occurs regardless of target performance appraisal. Study 4 indicates that expressing low PBJW decreases the social value of individuals, but expressing high PBJW does not increase it. We discuss the impact of PBJW expression on people's lives, namely on upward social mobility of members of low-status groups, and the influence of the negativity bias on judgments caused by PBJW expression.     

Depression in youth: psychosocial interventions

Witnessed over the past 20 years are major advances in knowledge regarding depression in children and adolescents. Although additional research is needed, clinicians can now turn to treatment strategies with demonstrated efficacy. In this article we review the literature on psychosocial interventions for depression in youth and offer a working model to guide the treatment of depressed youth. We begin with a brief overview of the model, followed by a review of the treatment efficacy and prevention literatures. We offer some caveats that impact the ability to move from this treatment literature to the real world of clinical practice. We conclude by considering how extant research can inform treatment decisions and highlight critical questions that need to be addressed through future research.     

"Perhaps it would be better not to know everything."

The advent of statistical methods for evaluating the data of individual-subject designs invites a comparison of the usual research tactics of the group-design paradigm and the individual-subject-design paradigm. That comparison can hinge on the concept of assigning probabilities of Type 1 and Type 2 errors. Individual-subject designs are usually interpreted with implicit, very low probabilities of Type 1 errors, and correspondingly high probabilities of Type 1 errors, and correspondingly high probabilities of Type 2 errors. Group designs are usually interpreted with explicit, moderately low probabilities of Type 1 errors, and therefore with not such high probabilities of Type 2 errors as in the other paradigm. This difference may seem to be a minor one, considered in terms of centiles on a probability scale. However, when it is interpreted in terms of the substantive kinds of results likely to be produced by each paradigm, it appears that the individual-subject-design paradigm is more likely to contribute to the development of a technology of behavior, and it is suggested that this orientation should not be abandoned.     

Brief anger interventions with offenders may be ineffective: A replication and extension

Anger-management interventions are widely delivered in the criminal justice and forensic mental health systems. Whilst previous research has generally supported the thesis that anger management is an effective intervention for anger problems in general there remains a need to determine its effectiveness with offender populations. This paper reports the results of a controlled outcome study of a 20 h anger-management program offered to offenders. Those receiving treatment showed improvements in their knowledge about anger, but showed little change on measures of anger and anger expression when compared to waiting-list controls. Scores on measures of treatment readiness and level of need for treatment were however, correlated with post-treatment improvement. These findings are discussed in terms of their implications for the assessment and selection of appropriate participants for offender anger-management programs.     

More is not always better: paradoxical effects of repetition on semantic accessibility

Repetition normally enhances memory. While in some cases the benefit of added repetition may be incremental, few would expect that massed repetition could actually reverse the benefits of brief repetition. Here we report two experiments that document a clear example of a paradoxical effect of massed repetition. Subjects first repeated words (e.g., "sheep") aloud one at a time for 0, 5, 10, 20, or 40 s. A free association phase followed in which cues could be completed with repeated words (e.g., "herd s___" for "sheep") or with semantically associated words (e.g., "fabric w___" for "wool"). Brief periods of repetition (5-10 s) resulted in priming, as would be expected based on research on repetition priming and spreading activation. Longer periods of repetition (20-40 s), however, abolished priming. Interestingly, this massed-repetition decrement was particularly robust for semantic associates of repeated words, and was evident after a 15-min delay. These findings document a paradoxical feature of the effects of rehearsal on memory: When ideas are repeated often enough, the benefits of rehearsal can actually be reversed.     

Behavioral interventions may prolong remission in patients with inflammatory bowel disease

Inflammatory Bowel Diseases (IBDs) are chronic, relapsing and remitting gastrointestinal conditions with no known cure. Previous studies have linked behavioral factors, including stress and medication adherence, to relapse.

Purpose

We sought to determine the effect of participation in a behavioral self-management program on incidence of flare within 12 months following behavioral intervention when compared to the natural history of flare incidence prior to program participation.

Results

Results from a 2-level regression model indicated that those participants in the treatment group were 57% less likely to flare in the following 12 months (compared to 18% in the control group). The decline in “flare odds” was about 2 times greater in treatment versus controls (OR = 0.52, t(34) = 2.07, p < 0.05). Office visits, ER visits, and disease severity (all p < 0.05) were identified as moderators of flare risk.

Conclusions

We have demonstrated 1) a statistical model estimating the likelihood of flare rates in the 12 months following a behavioral intervention for IBD (compared to a control condition), and 2) that the introduction of a behavioral intervention can alter the natural course of a chronic, relapsing and remitting gastrointestinal condition such as IBD.     

Ethical issues in psychosocial interventions research involving controls

Psychiatric research is of critical importance in improving the care of persons with mental illness. Yet it may also raise difficult ethical issues. This article explores those issues in the context of a particular kind of research: psychosocial intervention research with control groups. We discuss 4 broad categories of ethical issues: consent, confidentiality, boundary violations, and risk-benefit issues. We believe that, despite the potential difficulties, psychosocial intervention research is vital and can be accomplished in an ethical manner. Further discussion and research into these issues are warranted.     

More is not necessarily better: Examining the nature of the temporal reference memory component in timing

Three experiments compared the timing performance of humans on a modified temporal generalization task with 1, 3, or 5 presentations of the standard duration. In all three experiments subjects received presentations of a standard duration at the beginning of a trial block and then had to judge whether each of a number of comparison stimuli was or was not the standard. The duration of the standard changed between blocks. The three experiments varied the experimental design (between or within subjects), task difficulty (how closely the comparison stimuli were spaced around the standards), and presence or absence of feedback on performance accuracy. Number of presentations of the standard never affected the proportion of identifications of the standard when it was presented, nor other features of the temporal generalization gradients observed. The implications for the operation of reference memories within the scalar timing system were explored via models that made different assumptions about how the individual presentations of the standard were stored and used.     

Intra-regional assortative sociality may be better explained by social network dynamics rather than pathogen risk avoidance

Fincher & Thornhill's (F&T's) model is not entirely supported by common patterns of affect behaviors among people who live under varying climatic conditions and among people who endorse varying levels of (Western) religiosity and conservative political ideals. The authors' model is also unable to account for intra-regional heterogeneity in assortative sociality, which, we argue, can be better explained by a framework that emphasizes the differential expression of fundamental social cues for maintaining distinct social network structures.     

Words may not be enough! No increased emotional Stroop effect in obsessive-compulsive disorder

Conflicting evidence has been obtained whether or not patients diagnosed with obsessive-compulsive disorder (OCD) share an attentional bias towards disorder-related stimuli. Some of these inconsistencies can be accounted for by suboptimal stimuli selection. In consideration of the heterogeneity of OCD, we investigated Stroop interference effects for two classes of OCD items (i.e., washing and checking) in 23 OCD patients and 23 healthy controls. In order to cover prevalent OCD concerns, item compilation was based on experts' appraisals. Patients neither displayed greater immediate as well as delayed Stroop interference nor any bias for OCD and subtype-congruent stimuli. On the contrary, for washing-related items, OCD patients, and here especially washers, displayed facilitation relative to healthy controls. Although the present study at first sight refutes the notion of an attentional bias in OCD in contrast to other anxiety disorders, several potential moderators need to be considered before this account is ultimately dismissed. In particular, an attentional bias may only be elicited using visual material that is more attention-grabbing than verbal stimuli. Finally, blockwise instead of random item administration and greater consideration of individual relevance may be crucial prerequisites for the effect to emerge.     

A methodology for describing and decomposing complex psychosocial and behavioral interventions

This article presents a comprehensive conceptual framework and methodology for characterizing multidimensional psychosocial and behavioral interventions for family caregivers of people with Alzheimer's disease. The methodology involved conducting a detailed task analysis of the interventions, and the application of the analytical hierarchy process. The authors were able to achieve high levels of consistency and reliability using this methodology to decompose and describe the interventions according to a complex conceptual framework comprising 3 dimensions: target domain, functional domain, and delivery system characteristics. Application of this methodology will enhance the ability to describe and measure interventions consistently, make comparisons across studies, isolate causal factors that achieve desired outcomes, and more generally elevate the science of psychosocial intervention research.