The Psychosocial Impact of Undergoing Prophylactic Total Gastrectomy (PTG) to Manage the Risk of Hereditary Diffuse Gastric Cancer (HDGC)

Individuals identified as at high risk of developing Hereditary Diffuse Gastric Cancer (HDGC) are advised to undergo prophylactic surgery - have their stomach removed - in their early twenties. Research with (older) cancer patients who undergo gastrectomy for curative reasons suggests that gastric resection has a number of physical and psychosocial sequelae. Because it is difficult to extrapolate the findings of studies of older cancer patients to younger healthy patients who are considering prophylactic total gastrectomy (PTG), the aim of this qualitative interview study was to determine the psychosocial implications of undergoing prophylactic surgery to manage genetic risk. Fourteen men and 13 women from the UK’s Familial Gastric Cancer study who had undergone PTG were invited to participate in qualitative interviews. Most reported that undergoing surgery and convalescence was easier than anticipated. There was evidence that age affected experiences of PTG, with younger patients tending to report faster recovery times and more transient aftereffects. All saw the benefits of risk reduction as outweighing the costs of surgery. Surgery was described as having a range of physical impacts (disrupted appetite, weight loss, fatigue, GI symptoms) that had related psychological, social and economic implications. Those considering PTG need to be aware that its impact on quality of life is difficult to predict and negative sequelae may be ongoing for some individuals.     

Clients in Treatment for Alcohol Problems: Treatment Experiencesand Outcomes

This report presents an analysis of National Treatment Improvement Evaluation Study data describing the characteristics and treatment experiences of clients entering treatment for alcohol problems. Three client groups were contrasted—those entering treatment for alcohol only, for alcohol plus other drugs, or for other drugs only. Clients using alcohol only were more often white, male, and currently employed. Alcohol only clients were treated predominantly in outpatient settings. Alcohol only clients were frequently referred to treatment by the criminal justice system, and less often self-referred. In all 3 study groups, employment, general health, and mental health outcomes were improved following treatment. Illicit drug use increased marginally for the alcohol only group following treatment. No significant posttreatment reductions in reports of total abstinencefrom alcohol were found for any of the groups. Findings are discussed as they relate to research, treatment practice, and policyareas.     

Why are familiar-only experiences more frequent for voices than for faces?

Hanley,Smith, and Hadfield (1998) showed that when participants were asked to recognize famous people from hearing their voice , there was a relatively large number of trials in which the celebrity's voice was felt to be familiar but biographical information about the person could not be retrieved. When a face was found familiar, however, the celebrity's occupation was significantly more likely to be recalled. This finding is consistent with the view that it is much more difficult to associate biographical information with voices than with faces. Nevertheless, recognition level was much lower for voices than for faces in Hanleyet al.'s study,and participants made significantly more false alarms in the voice condition. In the present study, recognition performance in the face condition was brought down to the same level as recognition in the voice condition by presenting the faces out of focus. Under these circumstances, it proved just as difficult to recall the occupations of faces found familiar as it was to recall the occupations of voices found familiar. In other words, there was an equally large number of familiar-only responses when faces were presented out of focus as in the voice condition. It is argued that these results provide no support for the view that it is relatively difficult to associate biographical information with a person's voice. It is suggested instead that associative connections between processing units at different levels in the voice-processing system are much weaker than is the case with the corresponding units in the face-processing system. This will reduce the recall of occupations from voices even when the voice has been found familiar. A simulation was performed using the latest version of the IAC model of person recognition (Burton, Bruce, & Hancock, 1999) which demonstrated that the model can readily accommodate the pattern of results obtained in this study.