Social Constraints on Disclosure and Adjustment to Cancer

This article introduces the concept of social constraints on disclosure, puts it in a theoretical framework, and examines how it can affect adjustment to major life stressors using the exemplar of cancer. Cancer is a leading cause of death and disability worldwide. It is often life threatening, disfiguring, and unpredictable; hence, it can undermine people's basic and often positive beliefs and expectations about themselves, their future, and social relationships. For many people with cancer, it is important to come to terms psychologically with the illness – to make sense of or somehow accept the reality of it. People often do this by thinking about different aspects of the disease and its implications for their life, but also through socially processing, or talking about, their cancer-related thoughts, feelings, and concerns with others. When people experience social constraints on their disclosure of cancer-related thoughts and feelings, it can adversely affect how they think and talk about their illness, their coping behaviors, and psychological adjustment. In addition to discussing mechanisms and consequences of social constraints on disclosure, we discuss some of its determinants and future research directions.     

It's not that bad: Social challenges to emotional disclosure enhance adjustment to stress

Studies conducted in the United States (n=115) and Spain (n=146) examined how talking about an acute stressor in different social contexts influences cognitive, emotional, and physiological adjustment. In both studies, female college students viewed a video dramatizing a real-life, gang rape scene on two separate days. After the first viewing, participants were randomly assigned to one of four social conditions: no talk, talk alone about their reactions, talk to a validating confederate about their reactions, or talk to a challenging confederate about their reactions. Participants in the challenge condition showed the greatest emotional, cognitive, and physiological benefits across cultures, whereas participants in the validate and talk conditions evidenced only modest benefits. These findings suggest that the social context of disclosure has a strong influence on adjustment processes and that providing an alternative and more sanguine perspective can help individuals recover from acute stressors.     

Violence Exposure, Sleep Disturbance, and Poor Academic Performance in Middle School

Violence has been linked to poor academic outcomes in youth, but there is little understanding of the mechanisms underlying this relation. This longitudinal survey study investigated whether sleep disturbance potentially mediates the associations between academic achievement and two forms of violence exposure--community violence and peer victimization-- in 498 seventh-grade youth. Structural equation models showed that community violence was associated with lower grade point average (GPA) directly and indirectly via sleep problems, whereas peer victimization was associated with lower GPA just indirectly via sleep problems. The structural models controlled for potential confounds, including depressive symptoms, intrusive thoughts and absenteeism. The findings suggest that failing grades and sleepiness in school may be signs that youth are exposed to violence. Interventions to improve sleep hygiene and reduce violence exposure may help to improve academic outcomes for youth.     

Event-related potentials to overlapping shapes: Effects of saliency and interference

Visual perception is often challenged by various difficulties that act concomitantly and whose respective impacts may therefore be hard to distinguish. We used event-related potentials to dissociate the impact of target saliency, generated by occlusion, from that of interference produced by incongruent nontargets. In one block, the target (a square) partially occluded another square tilted by 45°. This nontarget square interfered only to a small extent with target perception. In another block, the target was the occluded stimulus, and interference from the nontarget was substantial. Blocks including two kinds of overlapping shapes (a cross and a square) were added to control for the interference effect. Block comparisons revealed that occlusion modulated an occipital N250 and reaction times. In contrast, interference modulated a parietal N380 but not reaction times.     

Improving quality of life in men with prostate cancer: a randomized controlled trial of group education interventions.

Men who were recently treated for prostate cancer (N=250) were randomly assigned to a control group, a group education intervention (GE), or a group education-plus-discussion intervention (GED). Both GE and GED increased prostate cancer knowledge. In the year postintervention, men in the GED condition were less bothered by sexual problems than men in the control condition, and they were more likely to remain steadily employed (93.0%) than men in the GE (75.6%) or control (72.5%) conditions. Among noncollege graduates, GED and GE resulted in better physical functioning than the control condition, and GED resulted in more positive health behaviors than the control or GE condition. Among college graduates, controls were comparable with the GE and GED groups in physical functioning and positive health behaviors.     

Developmental and gender differences in anonymous support-seeking: Analysis of data from a community help line for children

Calls to a community help line for children were analyzed for developmental and gender trends in support-seeking during middle childhood. Results indicated that between the ages of 10 and 11 the nature of help-seeking by callers changed, with a shift toward more informational support-seeking and concern regarding interpersonal problems. This shift was particularly dramatic for girls. Gender differences in the type of support sought (informational vs. instrumental) were slight. Parallels with other studies of stress and coping in children are drawn.     

Men's Adjustment to Prostate Cancer: The Role of Agency and Unmitigated Agency

We examined how two male gender-related traits, agency (focus on self) and unmitigated agency (focus on self to the exclusion of others), were related to physical and emotional functioning in 162 men (92% Caucasian) treated for prostate cancer. As predicted, unmitigated agency was associated with worse functioning and more cancer-related difficulties. By contrast, agency was associated with better functioning and fewer cancer-related difficulties. We tested whether difficulties expressing emotions explained these relations. Unmitigated agency was associated with difficulty expressing emotions, and agency was associated with the ability to express emotions. Structural equation modeling was used to show that emotional expressiveness mediated the relations of unmitigated agency and agency to adjustment to prostate cancer. The implications of these results for interventions to enhance men's adjustment to prostate cancer are discussed.     

On the nature of nonverbal working memory fractionation: a case of selective spatial short-term memory deficit in a child

Several lines of research on adult subjects demonstrate a visual/spatial fractionation of nonverbal working memory (WM), while behavioral studies on normal children support the idea of a static/dynamic distinction. In the present paper, we report a child (Z.M.) who failed on nonverbal WM tasks. To verify the nature of his defect, we carried out two experiments: in Experiment 1, Z.M. failed on spatial WM tasks but not on visual WM tasks and was not affected by the static/dynamic format of stimulus presentation; in Experiment 2, this visual/spatial dissociation was extended to the imagery domain. These results are best accounted for within the visual/spatial fractionation of WM and confirmed the role of WM in mental imagery. Clinical and rehabilitative implications of the present findings are also discussed.