Persistent symptoms among survivors of Hodgkin's disease: an explanatory model based on classical conditioning.

Persistent symptoms of nausea, distress, and vomiting triggered by reminders of cancer treatment were examined among 273 Hodgkin's disease survivors, 1 to 20 years posttreatment. Prevalence rates were high for distress and nausea but low for vomiting. Retrospective report of anticipatory symptoms during treatment was the strongest predictor of persistent symptoms, suggesting that treatment-induced symptoms are less likely to persist if conditioning does not occur initially. Time since treatment was also a significant predictor, with patients more recently treated more likely to experience persistent symptoms. Thus, an explanatory model based on classical conditioning theory successfully predicted presence of persistent symptoms. Symptoms also were associated with ongoing psychological distress, suggesting that quality of life is diminished among survivors with persistent symptoms. Recommendations for prevention and treatment of symptoms are discussed.     

The role of maltreatment experience in children's understanding of the antecedents of emotion

The ability to understand the causes and likely triggers of emotions has important consequences for children's adaptation to their social environment. Yet, little is currently known about the processes that contribute to the development of emotion understanding. To assess how well children understood the antecedents of emotional reactions in others, we presented children with a variety of emotional situations that varied in outcome and equivocality. Children were told the emotional outcome and asked to rate whether a situation was a likely cause of such an outcome. We tested the effects of maltreatment experience on children's ability to map emotions to their eliciting events and their understanding of emotion–situation pairings. The present data suggest that typically developing children are able to distinguish between common elicitors of negative and positive events. In contrast, children who develop within maltreating contexts, where emotions are extreme and inconsistent, interpret positive, equivocal, and negative events as being equally plausible causes of sadness and anger. This difference in maltreated children's reasoning about emotions suggests a critical role of experience in aiding children's mastery of the structure of interpersonal discourse.