Mastectomy versus breast conservation surgery: mental health effects at long-term follow-up.

Between 1984 and 1989, 129 Stage 1 and Stage 2 breast cancer patients were entered into a behavioral study in Pittsburgh. Approximately 70% of these patients had elected to have breast conservation (lumpectomy) surgery, with the remainder choosing mastectomy. Using the Profile of Mood States, a measure of perceived social support, and Karnofsky ratings of physical functional status, patients were assessed 3 to 5 days following surgery and again 3 and 15 months following surgery. The data were analyzed using a repeated-measures analysis of covariance, adjusting for aggressiveness of chemotherapy. Compared to mastectomy patients, patients who received breast conservation surgery were rated as more functional by observers, but they perceived themselves as having less energy and less emotional support, especially over the first 3 months of the recovery period. Because there is accumulating evidence that emotional support may act as a stress buffer in various populations and may have survival value, these findings may be particularly troublesome. This study shows that breast conservation surgery is not a psychosocial panacea. Patients whose breasts are spared, especially younger patients, have psychological symptoms that appear acutely worse in the short run and, in the end, are similar to those of patients who elect to have mastectomies. Therefore, patients choosing lumpectomies are not necessarily psychosocially better off than those electing to have mastectomies. Additionally, these patients, particularly younger patients, may require greater social support and potential mental health interventions than they seem to be receiving.     

Relational Entitlement,Early Recollections of Parental Care,and Attachment Orientation

The present study examined whether inadequate parental care has a long-term impact on pathological relational entitlement in romantic relations, and whether this impact is mediated by insecure attachment style. Our cohort of 335 Israeli adults completed Sense of Relational Entitlement (SRE), Experience in Close Relationships (ECR), and Parental Bonding Instrument (PBI) questionnaires. The results generally supported our hypotheses. Avoidant attachment style fully and negatively mediated the link between maternal adequate care and SRE total entitlement. Anxious attachment style fully and negatively mediated the link between PBI paternal adequate care and SRE total entitlement. Women were found to report more relational entitlement. These results support the notion that pathological relational entitlement has its roots in recollections of early parental care and attachment experiences. The results of the study are discussed in the context of adult attachment and romantic relationships.     

Performance appraisal reactions: measurement, modeling, and method bias

In this study, the authors attempted to comprehensively examine the measurement of performance appraisal reactions. They first investigated how well the reaction scales, representative of those used in the field, measured their substantive constructs. A confirmatory factor analysis indicated that these scales did a favorable job of measuring appraisal reactions, with a few concerns. The authors also found that the data fit a higher order appraisal reactions model. In contrast, a nested model where the reaction constructs were operationalized as one general factor did not adequately fit the data. Finally, the authors tested the notion that self-report data are affectively driven for the specific case of appraisal reactions, using the techniques delineated by L. J. Williams, M. B. Gavin, and M. L. Williams (1996). Results indicated that neither positive nor negative affect presented method biases in the reaction measures, at either the measurement or construct levels.     

Image of aging scale

The development of the Image of Aging Scale is described. It ineludes positive and negative images of elders within nine domains. The scale showed good 1-wk. test-retest reliability, internal consistency, and convergent validity.     

Peer Effects in Drug Use and Sex Among College Students

Past research suggests that congregating delinquent youth increases their likelihood of problem behavior. We test for analogous peer effects in the drug use and sexual behavior of male (n = 279) and female (n = 435) college students, using data on the characteristics of first-year roommates to whom they were randomly assigned. We find that males who reported binge drinking in high school drink much more in college if assigned a roommate who also binge drank in high school than if assigned a nonbinge-drinking roommate. No such multiplier effect is observed for females, nor are multiplier effects observed for marijuana use or sexual behavior for either males or females. Students who did not engage in these behaviors in high school do not appear to be affected by their roommates high school behavior.     

The contingent smile: a meta-analysis of sex differences in smiling

The authors present a meta-analysis of sex differences in smiling based on 448 effect sizes derivedfrom 162 research reports. There was a statistically significant tendency for women and adolescent girls to smile more than men and adolescent boys (d = 0.41). The authors hypothesized that sex differences in smiling would be larger when concerns about gender-appropriate behavior were made more conspicuous, situational constraints were absent or ambiguous, or emotion (especially negative) was salient. It was also predicted that the size of the sex difference in smiling would vary by culture and age. Moderator analysis supported these predictions. Although men tend to smile less than women, the degree to which this is so is contingent on rules and roles.     

Transient spatial attention degrades temporal resolution

To better understand the interplay between the temporal and spatial components of visual perception, we studied the effects of transient spatial attention on temporal resolution. Given that spatial attention sharpens spatial resolution, can it also affect temporal resolution? To assess temporal resolution, we measured the two-flash fusion threshold When two flashes of light are presented successively to the same location, the two-flash fusion threshold is the minimal interval between the flashes at which they are still perceived as two flashes, rather than a single flash. This assessment of temporal resolution was combined with peripheral precuing--a direct manipulation of transient spatial attention. This allowed us to demonstrate, for the first time, that spatial attention can indeed affect temporal resolution. However, in contrast to its effect on spatial resolution, spatial attention degrades temporal resolution. Two attentional mechanisms that could account for both attentional effects--enhanced spatial resolution and reduced temporal resolution--are discussed.     

Screening for Medical and Neurodevelopmental Disorders for the Professional Counselor

This article reviews several assessment factors useful identifying the presence of a possible medical illness or neurodevelopmental disorder contributing to a client's adjustment problems. Use of behavioral observations, record reviews, brief neuro-behavioral screening tests, and the taking of a history are outlined that can assist in raising the index of suspicion for organic influence. Also addressed are issues pertaining to referral for medical and specialty assessments, including neuropsychological evaluation.