Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

Objective: Communication of cancer information is an important element of cancer control, but cancer fear may lead to information avoidance, especially when coping is low. We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress.

Design: Cross-sectional survey of 1258 population-based adults (58–70 years) in England.

Main outcome measures: Cancer fear (intensity and frequency), perceived psychosocial stress and cancer information avoidance. Control variables were age, gender, ethnicity, marital status and education.

Results: A quarter (24%) of respondents avoided cancer information. Ordinal logistic regression analyses showed main effects of psychosocial stress (OR = 1.17, 95% CI 1.07–1.29) and cancer fear: cancer information avoidance was lowest in those with no cancer fear (13%), followed by those with moderate (24%; OR = 2.15, 95% CI: 1.49–3.12), and high cancer fear (35%; OR = 3.90, 95% CI: 2.65–5.73). In the adjusted model, the interaction between cancer fear and stress was significant (OR = 1.14, 95% CI 1.004–1.29, p < .05): 40% of those with high fear/high stress avoided cancer information compared with 29% with high fear/low stress.

Conclusion: Cancer fear and psychosocial stress interact to produce disengagement with cancer-related information, highlighting the importance of affective processes to cancer control efforts.     

The relationship between post-trauma problem reporting and carer quality of life after severe head injury

Abstract

Head injury is a significant cause of death and disability. This study examined the quality of life of carers of individuals following severe head injury from the acute neurosurgical care period to one year post discharge from hospital. The contribution of patterns of problem reporting by patients and their carers to quality of life was examined. Carer psychosocial adjustment and individual quality of life evaluations were significantly poorer than general population levels and did not change over a one year period. However, significant increases in the number of problems reported were noted over time. No significant differences were found between patients and carers in the numbers of problems identified at each of three assessments, although the level of agreement about problems identified was quite low. Female patients reported significantly more problems than male patients. Carer problem reporting was found to significantly predict carer quality of life and psychosocial functioning to a greater extent than patient problem reporting, a pattern which emerged after the patient had been discharged from hospital. The study demonstrates increasing problem profiles and differing perceptions of patients and carers over time. Combined with a lack of improvement in carer quality of life over a one year recovery period, this highlights the need for longer-term professional support and advice services aimed at both patients and carers.     

Utility of the Multidimensional Health Profile—Psychosocial Functioning Scales (MHP-P) for Assessing Psychosocial Adjustment in Gastric Bypass Surgery Patients

This study examined the utility of the Multidimensional Health Profile—Psychosocial Functioning (MHP-P) for the preoperative assessment of gastric bypass surgery (GBS) applicants. The MHP-P, a 58-item screening inventory that assesses 4 psychosocial areas relevant to health (mental health, life stress, social resources, and coping skills), was administered to 449 morbidly obese patients who were being considered for GBS. Data were compared with the results of a much more lengthy assessment procedure involving a 273-item comprehensive biographical and medical history interview, the MMPI-2, the Basic Personality Inventory, and the Beck Depression Inventory. The 17 measures of the MHP-P showed highly significant correlations with other measures considered to be of relevance in GBS outcome, confirming the utility of the MHP-P as a cost-effective procedure for use in this clinical medical setting.     

Reconnecting the individual and the social in health psychology

Abstract

Much social psychological research has sought to distinguish itself from more ‘individualistic’ approaches to human cognition and personality. Much of this debate fails to take account of the interactions between social and intrapsychic processes which, it is argued, are vital to the formulation of unifying theoretical principles and to practical applications in the field of health psychology. A general theoretical perspective is outlined, based on notions of connectionist systems operating at both the individual and interpersonal level. A special feature is the assumption that we depend on communication with and from other people to attribute reality to our interpretations of events. The benefits of this perspective for health psychology are then illustrated in the contexts of attitude-behaviour relations, appraisals of risk and uncertainty, person-situation interactions, and group processes and social influence.     

Psychosocial correlates of eczema in a non-treatment-seeking population

Data from the Vietnam Experience Study were used to examine psychosocial correlates of eczema. Based upon the results of dermatologic examinations, three groups of male veterans were identified: (a) subjects with eczema (n = 80), (b) subjects with tinea (n = 282), and (c) subjects with no medical diagnosis (n = 176). These three groups were compared on measures of anxiety, depression, hostility, and social support. The Diagnostic Interview Schedule (Version III-A) was used to determine diagnoses of anxiety and depression and level of social support. MMPI Scales 2 and 7, the Wiggins content scale of Depression, and the Cook-Medley Hostility Scale were used to assess anxiety, depression, and hostility. Eczema subjects did not differ from tinea or no-disease control groups on dependent measures. These results are contrasted with previous studies of treatment-seeking patients, which showed greater prevalence of anxiety and depression among individuals with eczema. Directions for future research are suggested.This paper is taken from the first author's dissertation.