Impact of health,treatment and psychological factors on cognitive functioning after chemotherapy for early breast cancer

The aim of the current study was to review the extent that physical health, treatment and psychological factors contribute to cognitive dysfunction after chemotherapy for breast cancer. PubMed, Medline and PsychINFO searches of the literature published from 1995 to 2008 pertaining to chemotherapy for breast cancer and cognitive dysfunction were reviewed. There is currently insufficient evidence available to evaluate the effect of indirect factors (health, treatment and psychological) on cognitive functioning after chemotherapy. Fatigue and changes in endocrine function are the most frequently investigated factors, although conclusions are limited due to methodological shortcomings. The impact of other health and treatment factors has been inadequately addressed, with many variables examined in only one of the 22 reviewed studies. Importantly, although depression and anxiety can significantly influence neuropsychological test performance, mood has been inconsistently measured and analysed in regards to cognitive performance in this literature. In addition, indirect factors may affect cognitive domains differently, requiring further investigation of specific domains after chemotherapy. Because chemotherapy can negatively affect numerous organ systems and as yet no systematic investigations of health, treatment or psychological factors have been conducted, the authors conclude that it is currently premature to attribute all cognitive change after chemotherapy treatment to cytotoxic drugs.     

The supermom trap: Do involved dads erode moms' self‐competence?

Increasingly, husbands have been expected to share equally in the task of childrearing, especially when their wives are employed. This study examined reactions to these changes in a sample of 78 dual-earner couples with 8-month-old infants. When wives felt that their husbands were skillful caregivers, greater husbands' contribution to caregiving was associated with lower self-competence among wives. In contrast, wives' caregiving behavior was unrelated to their husbands' self-competence. None of these effects emerged for the self-liking component of self-esteem. Thus, despite increasingly egalitarian sex roles, employed mothers (but not their husbands) seem to be trapped between their desire for help with childrearing and the threat to their personal competence posed by failure to meet socially constructed ideals of motherhood.     

THE WIDENING SCOPE OF INDICATIONS FOR PERVERSION

Much has changed in clinical practice and theory that bears on the diagnosis and treatment of perversion since Freud's Three Essays on the Theory of Sexuality (1905). Definitions of perversion have been freed from assumptions of a heterosexual normality and from moralistic interpretations. The authors endorse the current emphasis on aggression and early narcissistic problems and include the notion of splitting and sexualized scenarios in their definition of perversion. They present several vignettes of male and female patients to demonstrate the debts owed to Freud's theories and the way in which their thinking differs. They emphasize the understanding of the transference‐countertransference picture and the patient's management and control of excitement.