Alleviation of Side Effects and Distress in Breast Cancer Patients by Cognitive-Behavioral Interventions: A Systematic Review and Meta-analysis

Cognitive and behavioral interventions (CBI) have been used for breast cancer patients with various stages of the disease or undergoing different treatments. However, no quantitative review has summarized their efficacy on the side effects of treatment, distress, and quality of life in the acute treatment setting after diagnosis. This meta-analysis synthesizes data from 19 randomized clinical trials in order to: (a) provide an estimation of overall effect of CBI in breast cancer patients during treatment for breast cancer, i.e., neo-adjuvant and adjuvant treatment; (b) provide average effect sizes on side effects of treatment, distress, and quality of life; and (c) test possible moderators of effect size. The results show that CBI yielded a small effect size overall, specifically on general side effects of treatment, nausea, vomiting, distress, and quality of life. Individual and behavioral interventions seem to elicit better results on distress and on general side effects of treatment, respectively. While more studies are needed with regard to specific side effects (i.e., fatigue, pain, and sleep disturbance), the overall results clearly support the use of CBI in breast cancer patients during treatment.     

Ethics and Confidentiality for Psychologists in Academic Health Centers

Psychologists in academic health centers (AHC) face important ethical issues including confidentiality when working with a multidisciplinary team, sharing of information through the electronic health record, obtaining informed consent in a fast-paced healthcare environment, cultural competency in the medical setting, and issues related to supervision and training. The goal of this paper is to describe ethical issues for psychologists in AHCs in the context of case examples, and to consider ethical decision-making tools to enhance clinical care. Considerations for best practices in integrated care settings will be discussed, and the APA Ethical Standards will be referenced throughout.     

Validation Study of the Portuguese Version of the Family Problem Solving Communication (FPSC) Index

Within family stress theories, the way in which families communicate about their hardships and issues is crucial for the family’s stress management and functioning. In the current study, we sought to validate the Portuguese version of the Family Problem Solving Communication (FPSC) Index and examine its psychometric properties. Developed within the context of the resiliency model of family stress, adjustment and adaptation, the FPSC is a ten-item self-report measure that assesses the family communication patterns that are likely to play a role in the family’s coping with hardships and difficulties. The participants were 332 individuals between 18 and 76 years who completed the FPSC and self-report measures of family hardiness and family functioning. A confirmatory factor analysis supported the original FPSC bifactorial structure, indicating the presence of two dimensions, Affirmative Communication and Incendiary Communication. Correlations between the scale’s total score and its dimensions with the measures of family hardiness and family functioning attested to its convergent validity. Furthermore, the index demonstrated respectable to very good internal consistency and temporal stability. In conclusion, the Portuguese version of the FPSC is a valid and reliable instrument that can support the development of future empirical studies focused on family problem solving communication, especially with regard to family adaptation in different contexts of adversity.     

Emotional Separation,Autonomy in Decision-Making,and Psychosocial Adjustment in Adolescence: A Proposed Typology

Adolescence is critical for learning autonomous behavior; however, little research is available on the most appropriate balance of the emotional and behavioral dimensions of autonomy for psychosocial adjustment during this period. In this study we present a novel autonomy typology that combines both these aspects, which can be implemented as autonomy in decision-making and emotional separation. Specifically, examined age differences in emotional separation and autonomy in decision-making during adolescence. We also assessed differences in psychosocial adjustment associated with profiles of autonomy typology, sex, and age. The participants were 567 adolescents (296 males and 271 females), aged between 12 and 18 years (M?=?14.48; SD?=?1.69), recruited in Spanish high schools. Each participant filled out questionnaires on identity commitment, self-esteem, emotional separation and autonomy in decision-making. The results showed that the most advantageous autonomy profile is ‘autonomous in decisions’ (those showing low emotional separation combined with autonomous behavior in decisions) which was associated with higher levels of self-esteem and occupational and ideological identity commitment. In addition, we also concluded that the balance of autonomy affects adjustment throughout adolescence, although early adolescence may be an especially critical period.     

A safety mechanism for observational learning

This empirical article presents the first evidence of a “safety mechanism” based on an observational-learning paradigm. It is accepted that during observational learning, a person can use different strategies to learn a motor skill, but it is unknown whether the learner is able to circumvent the encoding of an uncompleted observed skill. In this study, participants were tested in a dyadic protocol in which an observer watched a participant practicing two different motor sequences during a learning phase. During this phase, one of the two motor sequences was interrupted by a stop signal that precluded motor learning. The results of the subsequent retention test revealed that both groups learned the two motor sequences, but only the physical practice group showed worse performance for the interrupted sequence. The observers were consequently able to use a safety strategy to learn both sequences equally. Our findings are discussed in light of the implications of the action observation network for sequence learning and the cognitive mechanisms of error-based observation.     

The role of visual experience in the production of emotional facial expressions by blind people: a review

Facial expressions of emotion are nonverbal behaviors that allow us to interact efficiently in social life and respond to events affecting our welfare. This article reviews 21 studies, published between 1932 and 2015, examining the production of facial expressions of emotion by blind people. It particularly discusses the impact of visual experience on the development of this behavior from birth to adulthood. After a discussion of three methodological considerations, the review of studies reveals that blind subjects demonstrate differing capacities for producing spontaneous expressions and voluntarily posed expressions. Seventeen studies provided evidence that blind and sighted spontaneously produce the same pattern of facial expressions, even if some variations can be found, reflecting facial and body movements specific to blindness or differences in intensity and control of emotions in some specific contexts. This suggests that lack of visual experience seems to not have a major impact when this behavior is generated spontaneously in real emotional contexts. In contrast, eight studies examining voluntary expressions indicate that blind individuals have difficulty posing emotional expressions. The opportunity for prior visual observation seems to affect performance in this case. Finally, we discuss three new directions for research to provide additional and strong evidence for the debate regarding the innate or the culture-constant learning character of the production of emotional facial expressions by blind individuals: the link between perception and production of facial expressions, the impact of display rules in the absence of vision, and the role of other channels in expression of emotions in the context of blindness.     

The effects of smiling on perceived age defy belief

It is a common belief that smiling makes people appear younger. Empirical findings, however, suggest that smiling faces are actually perceived as older than neutral faces. Here we show that these two apparently contradictory phenomena can co-exist in the same person. In the first experiment, participants were first asked to estimate the ages of a series of smiling or neutral faces. After that, they were asked to estimate the average age of the set of neutral and smiling faces they had just evaluated. Finally, they were asked what effect smiling has on one’s perceived age. In the experimental session, smiling faces were perceived as older than neutral faces. Nevertheless, after the experiment, consistent with their retrospective evaluations, participants recalled smiling faces as being younger than the neutral faces. Experiment 2 replicated and extended these results to a set of emotional expressions that also included surprised faces. Smiling faces were again perceived as older than neutral faces, which were in turn perceived as older than surprised faces. Again, retrospective evaluations were consistent with the belief that smiling makes people look younger. The findings show that this belief, well-rooted in popular media, is a complete misconception.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

Adoptive versus Mixed Families: Child Adjustment,Parenting Stress and Family Environment

Recent research in adoption has considered the factors and processes that underlie the adjustment of children and families. However, little research has been conducted on certain types of adoptive families, specifically on families with both adoptive and biological children often designated as mixed families. This subject is addressed by the present study which also analyzes the association between the type of adoptive family and children’s outcomes—prosocial and problem behavior—parenting stress and the relational family environment. It also examines whether children’s gender, age at adoption and the number of children in the home moderate these effects. 102 parents of adoptive children (ACF) 33 parents of both adoptive and biological children (ABCF) and 102 parents of biological children (BCF) participated in the study. Target-children were aged from 6 to 12 years. The Portuguese versions of the SDQ-P, PSI-SF and FES (Interpersonal Relationship dimension) were used. Results showed that the type of adoptive family—ACF and ABCF—significantly explained the variance of children’s behavioral problems and parenting stress. The child’s gender was shown to moderate the relationship between ACF parents and their perception of child’s prosocial behavior. The results give relevant clues as to the importance of distinct outcomes in adoptive families—ACF and ABCF—compared to families with only biological children and should, therefore, be a resource for professionals involved in the adopters’ suitability assessment and adoption intervention.