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.     

Context fear learning specifically activates distinct populations of neurons in amygdala and hypothalamus

The identity and distribution of neurons that are involved in any learning or memory event is not known. In previous studies, we identified a discrete population of neurons in the lateral amygdala that show learning-specific activation of a c-fos-regulated transgene following context fear conditioning. Here, we have extended these studies to look throughout the amygdala for learning-specific activation. We identified two further neuronal populations, in the amygdalo-striatal transition area and medial amygdala, that show learning-specific activation. We also identified a population of hypothalamic neurons that show strong learning-specific activation. In addition, we asked whether these neurons are activated following recall of fear-conditioning memory. None of the populations of neurons we identified showed significant memory-recall-related activation. These findings suggest that a series of discrete populations of neurons are involved in fear learning in amygdala and hypothalamus. The lack of reactivation during memory recall suggests that these neurons either do not undergo substantial change following recall, or that c-fos is not involved in any such activation and change.     

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.