Cognitive epidemiology: With emphasis on untangling cognitive ability and socioeconomic status

This commentary touches on practical, public policy, and social science domains informed by cognitive epidemiology while pulling together common themes running through this important special issue. As is made clear in the contributions assembled here, and others (Deary, Whalley, & Starr, 2009; Gottfredson, 2004; Lubinski & Humphreys, 1992, 1997), social scientists and practitioners cannot afford to neglect cognitive ability when modeling epidemiological and health care phenomena. However, given the dominant concern about the confounding of general cognitive ability (GCA) and socioeconomic status (SES), and the extent to which SES is frequently seen as the primary cause of health disparities (while GCA is neglected as a possible influence in epidemiology and health psychology), some methodological applications for untangling the relative influences of GCA and SES are reviewed. In addition, cognitive epidemiology is placed in a broader context: Just as cognitive epidemiology facilitates an understanding of pathology (“at risk” populations, and ways to attenuate undesirable personal and social conditions), it may also enrich our understanding of optimal functioning (“at promise” populations, and ways to identify and nurture the human and social capital needed to develop innovations for saving lives, economies, and perhaps even our planet). Finally, while GCA is likely the most important dimension in the study of individual differences for modeling healthy behaviors and outcomes, other relatively independent dimensions of psychological diversity do add value (Krueger, Caspi, & Moffitt, 2000). For example, compliance has at least two psychological components: a “can do” competency component (ability) and a “will do” motivational component (conscientiousness). Ultimately, developing and modeling healthy behaviors, interpersonal environments, and medical maladies are best accomplished by teaming multiple dimensions of human individuality.     

Does a fitness factor contribute to the association between intelligence and health outcomes? Evidence from medical abnormality counts among 3654 US Veterans

We suggest that an over-arching ‘fitness factor’ (an index of general genetic quality that predicts survival and reproductive success) partially explains the observed associations between health outcomes and intelligence. As a proof of concept, we tested this idea in a sample of 3654 US Vietnam veterans aged 31–49 who completed five cognitive tests (from which we extracted a g factor), a detailed medical examination, and self-reports concerning lifestyle health risks (such as smoking and drinking). As indices of physical health, we aggregated ‘abnormality counts’ of physician-assessed neurological, morphological, and physiological abnormalities in eight categories: cranial nerves, motor nerves, peripheral sensory nerves, reflexes, head, body, skin condition, and urine tests. Since each abnormality was rare, the abnormality counts showed highly skewed, Poisson-like distributions. The correlation matrix amongst these eight abnormality counts formed only a weak positive manifold and thus yielded only a weak common factor. However, Poisson regressions showed that intelligence was a significant positive predictor of six of the eight abnormality counts, even controlling for diverse lifestyle covariates (age, obesity, combat and toxin exposure owing to service in Vietnam, and use of tobacco, alcohol, marijuana, and hard drugs). These results give preliminary support for the notion of a superordinate fitness factor above intelligence and physical health, which could be further investigated with direct genetic assessments of mutation load across individuals.     

Imagining the Future of Photoacoustic Mammography

How can a realistic ethical imagination about the future of a technology take shape? This article contains a reflection which is based on the experiences of an embedded ethicist in the context of biophysical research conducive to the development of photoacoustic mammography, which is intended for the non-invasive detection of breast cancer. Imagination in this context already informs the activities of the biophysical researchers, but its role is limited: biophysical future scenarios concentrate on the technological advances that photoacoustics could bring about. In this article it is argued that it is advisable to also consider the medical practice and the ways in which this practice is likely to change as an effect of the introduction of photoacoustic mammography into it. On the basis of this more encompassing imaginative endeavor it is possible to get a clearer idea about how new technologies are able to contribute to human well being, which is informative for the setting of research-goals/priorities and a responsible implementation of new technologies into the world.     

The Relationship Between Religious Coping Style and Anxiety over Breast Cancer in African American Women

In this study, we investigated the relationship between religious coping style and anxiety related to breast cancer and the use of mammography in a sample of African American women. We also assessed the relationship of breast cancer anxiety to related variables such as church affiliation and attendance, church teachings on health, and acceptance of those teachings.     

食管癌研究的历史回顾和哲学思考

食管癌研究可分为病因学、发病机制和防治三个部分,涵盖了流行病学、生物化学、病理学、肿瘤学、分子生物学等多个学科。尽管两千多年前,我国学者以开始记载和描述食管癌,但直到近代特别是现代科学技术的进步才对食管癌有了系统的认识。回顾食管癌的研究史,不难看出,正确的研究方法和科学思路在揭示食管癌发病机制和控制食管癌发病率和死亡率中起关键的作用。辨证地剖析机体内部和外界环境之间的关系,人群研究和实验室研究,个体化局部治疗和全身综合治疗,基础和临床研究,传统方法和现代高科技的有机结合,国内外合作研究与小范围研究,研究者与食管癌患者之间的关系等方面的关系,是指导食管癌 研究的重要环节。     

Qualitative Cancer Genetic Counseling Research, Part II: Findings from a Exploratory Ethnographic Study in a Cancer Clinic

This is a report of the preliminary findings of a brief exploratory ethnographic study in a cancer diagnosis and treatment clinic. The main research purpose was to explore the meaning of cancer and cancer treatment to patients themselves and to their relatives and close friends. The methods are described in detail in a paper focusing on the experiences of being a novice ethnographer (Peters et al. (2001) J Genet Counsel 10(2):133–150.). The preliminary results of this exploratory fieldwork indicate that the experience of attending a cancer treatment clinic for evaluation and/or treatment is a complex social, emotional as well as medical process for patients and families. Themes with relevance to genetic counselors that emerged from this early observation period included ideas about causes of cancer, the complex nature of families and kinship, coping and support, use of food, and healing. These initial findings have implications for genetic counseling practice and hopefully will stimulate more qualitative social and behavioral research in cancer genetic counseling.     

Posttraumatic Stress in Survivors of Childhood Cancer and Mothers: Development and Validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS)

This study presents initial data validating the use of a new instrument, the Impact of Traumatic Stressors Interview Schedule (ITSIS), to assess the occurrence of cancer-related posttraumatic stress in childhood cancer survivors and their mothers. Sixty-six child/adolescent cancer survivors and 64 of their mothers, as well as 130 young adult survivors, completed the ITSIS and other measures of posttraumatic stress and general distress. Five ITSIS factors were identified for the mothers and for the young adult survivors, and three ITSIS factors were identified for the child/adolescent survivors. Factors in all three samples reflected symptoms of posttraumatic distress, concern over medical late effects, communication, and changes in self due to cancer. Only young adult survivors had a factor reflecting a positive engagement with the cancer history. Factors correlated with validation measures in predicted ways. The findings further the conceptualization of posttraumatic stress in pediatric cancer by describing the traumatic experience for survivors and mothers. Comparing factors across samples allows an examination of different influences of cancer within families and over the course of development.     

Conceptual framework from the Paris Psychosomatic School: A clinical psychoanalytic approach to oncology1

This article presents further clinical material from the Paris Psychosomatic School ( Aisenstein, 2006 ). The Freudian foundations of psychosomatics are detailed and post-Freudian developments focusing on the contribution of the Paris Psychosomatic School are outlined, in particular, the somatizing process as a result of regression and the somatizing process as a result of drive unbinding. The authors argue that the latter possibly gives rise to progressive and serious illness leading to death. The relationship of classical psychoanalysis to psychotherapeutic treatment from the angle of the Paris school is commented on. The authors then turn to two clinical presentations of women suffering from breast cancer. The method of evaluating the patients’ capacities for undergoing psychotherapeutic treatment and their mental capacity for healing is discussed. The face-to-face psychoanalytic treatment undertaken with the second case is discussed. Finally, the authors recall Freud’s insistence after 1920 on the opposition of the life drives and the death drives, which placed self-destruction at the centre of psychic functioning. They conclude that current research in biology and medicine, notably research concerning programmed cell death, will converge with psychoanalytic psychosomatics to illuminate somatizing processes and demonstrate the relevance of psychoanalytic treatment to patients who are capable of mental reorganization in the course of their illness and medical treatment.     

Psychological distress and well-being in advanced cancer: The effects of optimism and coping

This study examined the relations among optimism, coping, functional status, and psychological adjustment in 75 adults diagnosed with cancer. Both the positive and the negative aspects of psychological adjustment were assessed. All participants had been diagnosed with advanced stages of cancer (i.e., Stages II, III, and IV). Participants completed three assessments across a 4-month time period. Both optimism and coping were associated with psychological adjustment, even after controlling for functional status and prior adjustment. Additionally, optimism and coping were differentially related to distress and well-being. Optimism was strongly and positively associated with well-being and inversely related to distress. Escape-Avoidance coping was positively associated with distress and Accepting Responsibility coping was negatively associated with well-being. Comparisons between the current and prior studies indicated that individuals who are diagnosed with more advanced stages of cancer or who have survived bone marrow transplantation exhibit higher levels of optimism than do healthy individuals and individuals with early-stage disease.