The Influence of Cancer-related Distress and Sense of Coherence on Anxiety and Depression in Patients with Hereditary Cancer

This study examines the association between Sense of Coherence and anxiety and depression amongst patients at risk of hereditary cancer receiving genetic counseling. When writing this article, 144 patients referred for genetic counseling due to a suspicion of hereditary cancer in the family were recruited for this multicentered longitudinal study on the psychosocial aspects of genetic counseling in Norway. A total of 96 (66%) patients responded to the follow-up survey distributed 6 months after genetic counseling. This survey included the Sense of Coherence-29 Scale, Impact of Event Scale, and Hospital Anxiety and Depression Scale. Multiple regression analyses were applied. Our results show association between cancer-related distress and symptoms of anxiety and depression. Sense of Coherence is significantly associated with both anxiety and depression. The hypothesis of Sense of Coherence buffering cancer-related distress and the possible impact of these findings for genetic counseling are discussed.     

Is Psychology Based on a Methodological Error?

It is believed a proven fact that variables in social and personality psychology match to normal distribution with its single peak. Multiple peaks are explained by independent variables. However, after a comprehensive data analysis of more than 8.000 patients and on the basis of a bio-psycho-social model with 27 scales, we arrived at the conclusion that normal distribution and the psychometric error theory cannot withstand critical analysis in large samples. Beyond the “truth” that is proved by distribution-dependent statistical inferences, there exists another “truth” that is denied by the empirical doctrine. This “truth” is influenced by compensatory belief systems and explains paradoxes in quality of life research. We hypothesize that items, referred to life risks are micro-stressors, triggering self-regulatory processes as a humanly inherent response, deeply anchored in human evolution. Especially when exposed to threatening experiences, self-focused attention generates amplified multimodal distributions and subverts the methodological premises by an ambivalence-bias between thrill and threat, hopes and fears, pleasure and pain, success and failure, etc. In this article we want to focus attention to the incommensurability between test theoretical axioms and the way people usually respond to self-focused items. We discuss basic distribution patterns and approach to an evolutionary theory of fluctuation of validity.

Debiasing of Pessimistic Judgments Associated with Anxiety: A Test of the Availability Heuristic

This investigation directly tested the Consider-An-Alternative debiasing procedure and the reduction of pessimistic threat-related judgments associated with anxiety. Two separate generation interventions were included to test the availability heuristic as a possible explanation of the debiasing effect. Participants were randomly assigned to one of three interventions and probability estimates of future threat-related events were completed in a repeated measures experimental design. Level of trait anxiety was measured to assign participants to “normal” and highly anxious groups. The data were analyzed in a 3 × 2 × 2 mixed factorial repeated measures ANOVA. The results found that only the short debiasing intervention showed a significant reduction of pessimistic judgments in comparison to the control group. The results were interpreted as supporting the availability heuristic as an explanation of the debiasing effect. Further analysis also suggested that the content of recall may be as important to the debiasing effect as ease of recall.     

A Psychometric Analysis of the Child Behavior Checklist DSM-Oriented Scales

The Child Behavior Checklist for Ages 6–18 (CBCL/6-18) possesses newly developed DSM-Oriented Scales, constructed through expert clinical judgment to match selected categories for behavioral/emotional problems as described in the DSM-IV. The present investigation examined the basic psychometric properties for all six DSM-Oriented Scales (i.e., Affective, Anxiety, Somatic, Attention-Deficit/Hyperactivity, Oppositional, and Conduct Scales) in a large clinical sample of children and adolescents (N = 673). Findings from the present study provide strong evidence for the reliability, as well as convergent and discriminative validity, of these scales. It appears that the DSM-Oriented Scales may provide accurate supplementary information that may be considered when formulating clinical diagnoses.

Assessment of self-conscious emotions: a Swedish psychometric and structure evaluation of the Test of Self-Conscious Affect (TOSCA)

The Test of Self-Conscious Affect (TOSCA) is a well-established scenario-based questionnaire assessing self-conscious emotions, such as shame and guilt, which have been shown to be differentially associated with a variety of functional, motivational, behavioral and health outcomes. The aim of this study was to evaluate the psychometric properties and internal structure of a Swedish version of TOSCA in a sample of 361 healthy adults. The psychometric properties and internal consistency of the Swedish version were at level with the original US TOSCA version for shame, guilt and detachment. The internal structure of the Swedish version was acceptable for shame, guilt and detachment but contained shortcomings in assessment of externalization.     

How to handle anxiety: The effects of reappraisal, acceptance, and suppression strategies on anxious arousal

It has been suggested that reappraisal strategies are more effective than suppression strategies for regulating emotions. Recently, proponents of the acceptance-based behavior therapy movement have further emphasized the importance of acceptance-based emotion regulation techniques. In order to directly compare these different emotion regulation strategies, 202 volunteers were asked to give an impromptu speech in front of a video camera. Participants were randomly assigned to one of three groups. The Reappraisal group was instructed to regulate their anxious arousal by reappraising the situation; the Suppression group was asked to suppress their anxious behaviors; and the Acceptance group was instructed to accept their anxiety. As expected, the Suppression group showed a greater increase in heart rate from baseline than the Reappraisal and Acceptance groups. Moreover, the Suppression group reported more anxiety than the Reappraisal group. However, the Acceptance and Suppression groups did not differ in their subjective anxiety response. These results suggest that both reappraising and accepting anxiety is more effective for moderating the physiological arousal than suppressing anxiety. However, reappraising is more effective for moderating the subjective feeling of anxiety than attempts to suppress or accept it.     

The sleep patterns and problems of clinically anxious children

Childhood sleep problems have been associated with a range of adverse cognitive and academic outcomes, as well as increased impulsivity and emotional disorders such as anxiety and depression. The aim of the study was to examine subjective reports of sleep-related problems in children with anxiety disorders during school and weekend nights. Thirty-seven children with clinically-diagnosed anxiety disorders and 26 non-clinical children aged 7-12 years completed an on-line sleep diary to track sleep patterns across school nights and weekend nights. Anxious children reported going to bed significantly later (p = 0.03) and had significantly less sleep (p = 0.006) on school nights compared to non-anxious children. No significant differences in sleep onset latency, number of awakenings or time awake during the night, daytime sleepiness, or fatigue were found between the two groups. On the weekends, anxious children fell asleep quicker and were less awake during the night than on weeknights. School-aged anxiety disordered children showed a sleep pattern that differs from their non-anxious peers. Although the mean 30 min less sleep experienced by anxious children may initially seem small, the potential consequences on daytime performance from an accumulation of such a sleep deficit may be significant, and further investigation is warranted.     

Using the Internet to provide cognitive behaviour therapy

A new treatment form has emerged that merges cognitive behaviour therapy with the Internet. By delivering treatment components, mainly in the form of texts presented via web pages, and provide ongoing support using e-mail promising outcomes can be achieved. The literature on this novel form of treatment has grown rapidly over recent years with several controlled trials in the field of anxiety disorders, mood disorders and behavioural medicine. For some of the conditions for which Internet-delivered CBT has been tested, independent replications have shown large effect sizes, for example in the treatment of social anxiety disorder. In some studies, Internet-delivered treatment can achieve similar outcomes as in face-to-face CBT, but the literature thus far is restricted mainly to efficacy trials. This article provides a brief summary of the evidence, comments on the role of the therapist and for which patient and therapist this is suitable. Areas of future research and exploration are identified.     

Nonstandard career paths and profiles of commitment to life roles: A complex relation

The career paths (ascending, interesting, uninteresting, descending) of 124 White Canadian francophones (62 men, 62 women) who had experienced nonstandard and precarious work for the last three years were examined in relation to the participants’ profiles of commitment to three life roles (work, family, and duality, that is, investment in both career and family). The paths were derived from the content analysis of the data collected through semi-structured individual interviews. Quantitative tools were used to assess the importance of life roles and to compare the career paths as well as the commitment profiles with respect to specific and general anxiety. Among other results, a significant relationship was found between unsatisfying career paths and the duality profile, on the one hand, and higher levels of specific and general anxiety, on the other. The results are discussed with respect to the scientific literature. Implications for career counseling are suggested.     

Improving access to psychological therapy: Initial evaluation of two UK demonstration sites

Recently the UK Government announced an unprecedented, large-scale initiative for Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders. Prior to this development, the Department of Health established two pilot projects that aimed to collect valuable information to inform the national roll-out. Doncaster and Newham received additional funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating on stepped-care principles, when appropriate. This article reports an evaluation of the new services (termed ‘demonstration sites’) during their first thirteen months of operation. A session-by-session outcome monitoring system achieved unusually high levels of pre to post-treatment data completeness. Large numbers of patients were treated, with low-intensity interventions (such as guided self-help) being particularly helpful for achieving high throughput. Clinical outcomes were broadly in line with expectation. 55-56% of patients who had attended at least twice (including the assessment interview) were classified as recovered when they left the services and 5% had improved their employment status. Treatment gains were largely maintained at 10 month follow-up. Opening the services to self-referral appeared to facilitate access for some groups that tend to be underrepresented in general practice referrals. Outcomes were comparable for the different ethnic groups who access the services. Issues for the further development of IAPT are discussed.