The regulation of subjective well-being in cancer patients: An analysis of coping effectiveness

Abstract

The hypothesis that individual coping efforts affect subjective well-being in the face of severe chronic disease is examined with questionnaire data from N=332 cancer patients in a one-year longitudinal study. After depicting conceptual and methodological requirements for the analysis of coping effectiveness, the following five coping modes were investigated in the sample: Rumination, search for affiliation, threat minimization, search for information and search for meaning in religion. Results from a series of hierarchical regression analyses yielded findings that questioned the underlying assumption of a general uniform causal direction within coping-adjustment relationships. Threat minimization proved to be the only coping mode that obviously was “effective” in well-being regulation, that is, was revealed to be predictive of well-being changes over time and to be unaffected by prior levels of well-being. It is argued that the problem of causal directionality has to be carefully examined in future studies on coping effectiveness since interindividual differences in coping behaviors might be a consequence rather than the cause of differences in adjustment status.     

Perceived positive and negative consequences after surviving cancer and their relation to quality of life

Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health‐related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer‐related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty‐one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN‐52 self‐reported version. Data were analysed using mixed methods approach. Overall, 87.8% of the studied sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer‐related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well‐being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well‐being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.     

A systematic review and narrative synthesis of occupational therapy-led interventions for individuals with anxiety and stress-related disorders

Anxiety and stress-related disorders are highly prevalent and impede participation in life activities. Occupational therapists work extensively with people diagnosed with these disorders but the effectiveness of their interventions is unclear. A systematic search strategy identified 19 papers describing 13 studies. Studies varied in methodology, intervention type, and theory base. The results show the potential for lifestyle approaches, occupational science-based programs, and skill-building to improve mental health. The variety of interventions and methodologies of many studies means that the effectiveness of occupational therapy interventions for this population is not yet determined. High-quality research is required to replicate interventions with emerging potential for effectiveness.     

Lived Experiences of Informal Settlers in Peri-Urban Districts in Zimbabwe

The study explored the lived experiences of informal settlers in two peri-urban cities of Zimbabwe (n=53, males=19, females=34; Age range 18 to 76 years). The settlers self-reported on aspects of wellbeing, including perceived neighborliness of habitats. Data were thematically analyzed. The informal settlers felt insecure, psychologically stressed and socially marginalized. Some reported being optimistic about the future and their life chances in general.     

Early lexical development of children raised in institutional care in Russia

Children abandoned to institutions display a host of developmental delays, including those involving general cognition and language. The majority of published studies focus on children over 3 years of age; little is known about whether these delays may be detected earlier when children undergo rapid lexical development. To investigate the early language development of children raised in institutional settings in the Russian Federation, we compared a group of children in institutional care (n = 36; 8–35 months) to their age-matched peers raised in biological families, who have never been institutionalized (n = 72) using the Russian version of the CDI. The results suggest that institutionalization is associated with pronounced delays in children's early language development with large and robust effect sizes. Among children with a history of institutionalization, these delays are also associated with difficulties in Daily Living skills, communication, and socialization.     

Working psychodynamically and psychosocially with women who have been raped

In this paper, I analyse aspects of the experience of some female University students who have been raped drawing on a Kleinian psychoanalytic perspective and Layton’s concept of ‘normative unconscious processes’. I suggest that Klein’s writing provides a theoretical basis for thinking about the projective and introjective processes that may be at play between perpetrator and ‘victim’. Here, I focus upon Kleinian conceptualisations of castration anxiety, fragmentation, envy, greed and guilt. In terms of ‘normative unconscious processes’, I explore how castration anxiety (in a more symbolic sense of powerlessness), fragmentation, envy, greed and guilt may also operate within social discourses around sexual violence. Specifically, I draw upon Freyd’s concept of DARVO and Payne’s Rape Myth Acceptance Scale which both explain ‘victim blaming’ in terms of the social reversal of the positions of perpetrator and ‘victim’. I illustrate this social process with reference to representations of rape within the mainstream media. My hypothesis is that, although the ‘psychic’ and the ‘social’ are two contrasting positions theoretically, it is possible to draw on both of them to make sense of the experience of working with rape clinically.

The clinical context of this paper is my work as a psychodynamic counsellor at a modern London-based University. I draw on composite case studies of women who have been raped, drawing on both ‘psychic’ and ‘social’ perspectives. I seek to explore how the ‘psychic’ and the ‘social’ can be integrated in different ways depending upon the clinical situation. I suggest that they can be mutually enriching ways of working. Through approaching how the ‘psychic’ and the ‘social’ might interrelate from a clinical viewpoint, I conclude that the idea of ‘working psychosocially’ is of most use when approached as a flexible concept that different clinicians may draw on in different ways with different patients.