Intrusive thoughts and avoidance in breast cancer: Individual differences and association with psychological distress

Abstract

Eighty-five women with newly diagnosed breast cancer were classified on the basis of high and low levels of cancer-related intrusive thoughts and avoidance at diagnosis, and their psychological adjustment was studied prospectively at 3 and 6 months post diagnosis. Patients who initially reported high levels of both intrusive thoughts and avoidance and those who reported high levels of intrusive thoughts but low avoidance experienced the highest levels of anxiety and depression symptoms, and continued intrusive thoughts and avoidance. Patients who were high in avoidance but low in intrusive thoughts also experienced adjustment problems, including increased intrusive thoughts, when compared with patients who were low in both types of symptoms. The findings highlight the value of considering subgroup differences in patterns of intrusion and avoidance as predictors of subsequent psychological adjustment to breast cancer.     

Millon Behavioral Medicine Diagnostic (MBMD) Predicts Health-Related Quality of Life (HrQoL) Over Time Among Men Treated for Localized Prostate Cancer

Prostate cancer treatment presents multiple challenges that can negatively affect health-related quality of life (HrQoL), and that can be further compromised by maladaptive personality styles and psychological adjustment difficulties. This study examined the utility of a comprehensive psychosocial screening tool to identify psychosocial traits that prospectively predict HrQoL status among men treated for localized prostate cancer. The Millon Behavioral Medicine Diagnostic (MBMD) was administered to 66 men (M age = 68 years, 59% White) treated by either radical prostatectomy or radiotherapy along with standard measures of general and prostate-cancer-specific quality of life assessed at a 12-month follow-up. Higher scores on both summary MBMD Management Guides (Adjustment Difficulties and Psych Referral) and higher scores on personality styles characterized by avoidance, dependency, depression, passive aggressiveness, and self-denigration predicted lower HrQoL (β range = –.21 to –.50). Additionally, higher scores on the MBMD Depression, Tension-Anxiety, and Future Pessimism scales predicted lower HrQoL. Finally, higher scores on the MBMD Intervention Fragility and Utilization Excess scale also consistently predicted poorer mental and physical health functioning over time. These results point to the utility of the MBMD to help screen for potential impairments in mental and physical health functioning in men undergoing treatment for prostate cancer.     

Lower limb kinematic variability in dancers performing drop landings onto floor surfaces with varied mechanical properties

Elite dancers perform highly skilled and consistent movements. These movements require effective regulation of the intrinsic and extrinsic forces acting within and on the body. Customized, compliant floors typically used in dance are assumed to enhance dance performance and reduce injury risk by dampening ground reaction forces during tasks such as landings. As floor compliance can affect the extrinsic forces applied to the body, secondary effects of floor properties may be observed in the movement consistency or kinematic variability exhibited during dance performance. The aim of this study was to investigate the effects of floor mechanical properties on lower extremity kinematic variability in dancers performing landing tasks. A vector coding technique was used to analyze sagittal plane knee and ankle joint kinematic variability, in a cohort of 12 pre-professional dancers, through discrete phases of drop landings from a height of 0.2 m. No effect on kinematic variability was observed between floors, indicating that dancers could accommodate the changing extrinsic floor conditions. Future research may consider repeat analysis under more dynamic task constraints with a less experienced cohort. However, knee/ankle joint kinematic variability was observed to increase late in the landing phase which was predominantly comprised of knee flexion coupled with the terminal range of ankle dorsiflexion. These findings may be the result of greater neural input late in the landing phase as opposed to the suggested passive mechanical interaction of the foot and ankle complex at initial contact with a floor. Analysis of joint coordination in discrete movement phases may be of benefit in identifying intrinsic sources of variability in dynamic tasks that involve multiple movement phases.     

The Phenomenology of Rooting

This paper examines the attractions of passionate involvement in wanting particular outcomes, which is popularly known as rooting. The author’s lifelong personal experience is the source of his analysis, along with the insights provided by spiritual literature and especially the work of Dr. Thomas Hora, with whom the author studied for 30 years. The phrase “choiceless awareness,” utilized by J. Krishnamurti, and attained via meditation, is seen as the means of transcending a rooting mode of being in the world.     

A Psychometric Analysis of the Revised Child Anxiety and Depression Scale—Parent Version in a Clinical Sample

The Revised Child Anxiety and Depression Scale—Parent Version (RCADS-P) is a 47-item parent-report questionnaire of youth anxiety and depression, with scales corresponding to the DSM-IV categories of Separation Anxiety Disorder, Social Phobia, Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive-Compulsive Disorder, and Major Depressive Disorder (MDD). The RCADS-P is currently the only parent-report questionnaire that concurrently assesses youth symptomatology of individual anxiety disorders as well as depression in accordance with DSM-IV nosology. The present study examined the psychometric properties of the RCADS-P in a large (N = 490), clinic-referred sample of youths. The RCADS-P demonstrated favorable psychometric properties, including high internal consistency, convergent/divergent validity, as well as strong discriminant validity—evidencing an ability to discriminate between anxiety and depressive disorders, as well as between the targeted anxiety disorders. Support for the DSM-related six-factor RCADS-P structure was also evidenced. This structure demonstrated superior fit to a recently suggested alternative to the DSM-IV classification of anxiety and affective disorders—namely, the MDD/GAD “distress” factor.     

Development and Evaluation of the Parental Beliefs about Anxiety Questionnaire

Although numerous parental styles, practices, behaviors, and beliefs have been linked to childhood anxiety, specific parental cognitions that are concurrently associated with parental and child anxiety have yet to be operationalized and measured in a single instrument. This investigation describes the development of a parent-report questionnaire designed to assess parental beliefs about their child’s anxiety, namely the Parental Beliefs about Anxiety Questionnaire (PBA-Q). This questionnaire demonstrated good internal consistency, reliability, and validity when evaluated in a general sample of clinically referred children and their parents. Exploratory factor analysis revealed a four-factor solution, suggesting that multiple facets might underlie the construct of parental beliefs about child anxiety. Results are discussed in terms of the importance of parental beliefs about the child’s anxiety to understanding the relationship between parental and child anxiety.     

The effects of ageing and cognitive impairment on on‐line and off‐line motor learning

Skilled performance is a collective function of practice‐related experiences (online learning) and post‐practice memory consolidation during sleep (offline learning). This study examines the effects of ageing and cognitive impairment on the on‐ and offline learning of a point‐to‐point arm movement. In a 3‐day experiment, older adults (cognitively normal or impaired) and young adults (YAs) were randomly assigned to practice or no‐practice conditions. Changes in the dependent measures of movement time and timing error were analysed within and between conditions across days. The findings suggest that both age and cognitive function affect skill learning. YAs improved performance via both on‐ and offline learning whereas older adults with normal cognitive capacities appeared to learn the movement skill primarily in an online mode. Cognitive impairments were found to hinder both types of skill learning. Implications for motor skill acquisition and rehabilitation are briefly discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

The cultural theory and model of suicide

A growing body of research has demonstrated important variations in the prevalence, nature, and correlates of suicide across ethnic and sexual minority groups. Despite these developments, existing clinical and research approaches to suicide assessment and prevention have not incorporated cultural variations in any systematic way. In addition, theoretical models of suicide have been largely devoid of cultural influence. The current report presents a comprehensive analysis of literature describing the relationship between cultural factors and suicide in three major ethnic groups (African Americans, Asian Americans, and Latinos) and LGBTQ¹ sexual minority groups. We utilized an inductive approach to synthesize this variegated body of research into four factors that account for 95% of existing culturally specific risk data: cultural sanctions, idioms of distress, minority stress, and social discord. These four cultural factors are then integrated into a theoretical framework: the Cultural Model of Suicide. Three theoretical principles emerge: (1) culture affects the types of stressors that lead to suicide; (2) cultural meanings associated with stressors and suicide affect the development of suicidal tendencies, one's threshold of tolerance for psychological pain, and subsequent suicidal acts; and (3) culture affects how suicidal thoughts, intent, plans, and attempts are expressed. The Cultural Model of Suicide provides an empirically guided cohesive approach that can inform culturally competent suicide assessment and prevention efforts in future research and clinical practice. Including both ethnic and sexual minorities in our investigations ensures advancement along a multiple identities perspective.     

A sensory origin for color-word stroop effects in aging: simulating age-related changes in color-vision mimics age-related changes in Stroop

An increase in Stroop effects with age can be interpreted as reflecting age-related reductions in selective attention, cognitive slowing, or color-vision. In the present study, 88 younger adults performed a Stroop test with two color-sets, saturated and desaturated, to simulate an age-related decrease in color perception. This color manipulation with younger adults was sufficient to lead to an increase in Stroop effects that mimics age-effects. We conclude that age-related changes in color perception can contribute to the differences in Stroop effects observed in aging. Finally, we suggest that the clinical applications of Stroop take this factor into account.