The value of stress-management interventions in life-threatening medical conditions

Emotional stress has been associated with the development and progression of several chronic medical conditions. Recently, researchers have assessed the impact of stress-management interventions on patients' psychological functioning, quality of life, and various disease outcomes, including survival. This review summarizes the value of stress-management techniques in the treatment of two important, life-threatening conditions: coronary heart disease and cancer. Results from randomized clinical trials indicate that psychological interventions can improve patients' psychological functioning and quality of life. However, there is limited evidence to suggest that these interventions significantly reduce morbidity and mortality.     

The Effect of Genetic Counseling on Knowledge and Perceptions Regarding Risks for Breast Cancer

In 1994, a clinic for cancer risk counseling was opened at Hadassah University Hospital in Jerusalem. Most of the counselees have been women who had breast cancer and/or a relative with breast cancer. In order to evaluate the effect of this counseling on women's knowledge and perceptions regarding the risks for breast cancer, a questionnaire was given before and after the counseling session to 60 healthy women who came to the clinic because they have relatives with breast cancer. According to the genetic counselors' estimations, most of these women had a significantly increased risk (compared to the general population) of developing cancer. Before counseling, the women overestimated the population risk for breast cancer, the contribution of heredity to morbidity of cancer, and their own risks to get cancer. After counseling session, they gave reduced estimates, closer to the real ones. The subjective perceptions regarding these risks were reduced after counseling, except for the perceptions regarding their relativerisks which have not changed after the counseling. About 90% of the women who came to the clinic wanted to be tested for genetic predisposition to cancer. For most of these women, the expectations that the test can rule out a genetic predisposition to cancer became more realistic after the counseling. The option to first test an affected relative was offered to all families, and a test was actually conducted in 75% of the families.     

Psychological Interventions and Genetic Testing: Facilitating Informed Decisions About BRCA1/2 Cancer Susceptibility

Genetic testing for inherited cancer susceptibility, based on the recently identified. BRCA1 and BRCA2 genes, will soon be available on a large scale. However, at present, genetic test results do not lead to clearly indicated diagnostic or preventive measures, and the nature of the psychological impact of BRCA1/2 testing is still largely unknown. This uncertainty, combined with preliminary evidence suggesting significant individual differences in reactions to genetic susceptibility feedback, constitutes a unique challenge for any individual contemplating such testing. We outline the nature of this challenge and then propose an intervention strategy designed to help individuals make deeply processed and psychologically well-informed decisions with regard to their genetic susceptibility. The intervention is guided by recent research findings and theory on the cognitive–emotional processing of cancer-risk information. Specifically, the goal is to prepare the individual for genetic testing by (1) cognitively and emotionally activating, or preliving, the individual's potential reactions to testing feedback; (2) facilitating accurate appraisal of the individual's cognitive–emotional reactions; and (3) enabling the individual to process these reactions through the use of well-established clinical techniques.     

Ethnocultural Influences in Cancer

Compelling evidence that ethnicity is associated with serious disparities in cancer morbidity and mortality has been documented in the medical and public health literature. In addition to the role that socioeconomic variables play in affecting cancer outcomes, health professionals are beginning to pay attention to the influence of ethnicity and culture. This paper examines the role that ethnocultural factors contribute to cancer, with particular attention to breast, cervical, prostate, and colorectal cancers. Young and Zane's adaptation of a process oriented model of how culture and ethnicity affect disease is proposed as a useful framework to understand the illness experience. It is suggested that attending to ethnocultural issues will assist health providers and researchers toward developing and implementing strategies to improve cancer outcomes among ethnic populations.     

Fatigue and Quality of Life Following Radiotherapy for Breast Cancer: A Comparative Study

Clinical reports suggest that fatigue is a common and disruptive long-term side effect of radiotherapy; however, there has been little systematic attention given to this phenomenon. The primary aim of this study was to assess fatigue its impact on quality of life in women who had completed radiotherapy for breast cancer. A key feature of this study was the inclusion of a comparison group of women of similar age with no history of cancer. The results indicated that the fatigue experienced by women after radiotherapy for breast cancer was not significantly different in intensity, duration, or disruptiveness from fatigue experienced by healthy women. In addition, radiotherapy recipients reported a quality of life similar to that of the healthy women. For both groups of women greater fatigue was related to a poorer quality of life. These findings suggest that following radiotherapy for breast cancer, women can expect to experience fatigue which is not worse than what they might normally experience. This information may be a useful part of psychoeducational interventions designed for women scheduled to begin radiotherapy for breast cancer.     

遗忘症患者外显与内隐记忆分离的实验研究：自由回忆与再认任务

采用WMS－CR和MMSE筛选了9名遗忘症患者,采用自由回忆和再认两项任务观察了他们及正常对照组的外显记忆。结果发现：遗忘症患者两项外显记忆任务操作呈分离现象,自由回忆任务操作明显受损,再认任务的操作尽管较对照组低,但与对照组差异未达显著性水平。推论;①外显记忆受患者损伤的颞叶或间脑结构调节。②再认任务至少包含两种性质不同的潜在加工过程,一种为意识性重组加工,另一种为无意识自动加工,两者相互独立地贡献再认任务的操作。正常人意识性重组加工的贡献占优势,掩盖了无意识的作用。遗忘症患者意识性重组加工损伤,无意识自动加工部分代偿作用。③先前研究未对遗忘症患者进行认知功能的筛选,患者对再认障碍可能源于其他认知功能障碍,而非记忆障碍之故。     

Comment on “The Impact of Cancer on Psychological and Social Outcomes (Costa et al., 2016)”

The review written by (Costa et al. 2016) summarises a broad range of topics associated with what is known about the psychosocial outcomes of cancer in patients and their families. This commentary supplements this review by expanding on three topics that were not covered in the review. First, the challenges in assessing and diagnosing anxiety, depression, and distress in cancer patients due to overlapping symptoms with the disease state are highlighted. Second, the contribution of biological pathways such as inflammation upon the genesis and maintenance of anxiety, depression, and distress is acknowledged. Third, the potential role of religion and spirituality in influencing the psychosocial outcomes of cancer is raised. These three points are used to emphasise the importance of firmly incorporating a biopsychosocial model in research and health‐care provisions with cancer patients and their families.     

The Implicit Image of God: God as Reality and Psychological Well‐Being

Research has widely demonstrated that religiosity is related to psychological well‐being even in situations of severe illness. To assess religious beliefs, explicit measures have generally been used. In this study, we measured the belief that God is reality as opposed to myth or abstraction by using an implicit technique (the Single Category Implicit Association Test). The study was carried out in Italy, where a large majority of the population is Catholic, and the prevailing image of God is that of a compassionate and supportive father. Participants were cancer patients identifying themselves as believers. As expected, the automatic belief that God is reality (vs. abstraction) was related to beneficial outcomes: lower reported psychophysical anxiety symptoms and a weaker use of avoidance strategies to cope with stress. Thus, also, automatic religious beliefs may affect feelings and behaviors.     

Mental health of outpatient pediatric patients

The purpose of this study is to estimate the percentage of mental health problems in a pediatric outpatient Norwegian clinic. We used the Strengths and Difficulties Questionnaire to screen for mental health problems. Families of children aged 4–11 took part in the study, and 380 out of 982 possible families consented to take part, and 349 families contributed with questionnaire data. The main referral reasons for the patients were asthma, eneuresis and stomach pain. Mothers reported that 17.4% of boys and 17.8% of girls displayed mental clinical problems. The prevalence of problems did not differ significantly between somatic diagnostic groups. Although the study has low participation, it underlines the necessity of screening all pediatric patients for mental health problems. Future research in pediatric clinics should include factors of psychology because pediatric problems are not caused by somatics alone.     

Do stigma and its psychosocial impact differ between Asian-born Chinese immigrants and Western-born Caucasians with head and neck cancer?

Stigma appears to influence emotional distress and well-being in cancer survivors, but cross-cultural differences have been ignored. Previous studies suggest that stigma may be especially relevant for survivors of Asian origin. However, their study designs (e.g. focused on female cancers, qualitative designs, and an absence of comparison groups) limit the strength of this conclusion. We hypothesized that (1) Asian-born Chinese immigrants (AI) would report more perceived cancer-related stigma than Western-born Caucasians (WBC); and (2) the impact of stigma on emotional distress and well-being would be greater in AI as compared to WBC. Head and neck cancer survivors (n = 118 AI and n = 404 WBC) completed measures of well-being, emotional distress, and a three-item indicator of stigma in structured interviews. The majority of respondents (59%) reported one or more indicators of stigma. Stigma correlated significantly with emotional distress (r = .13, p = .004) and well-being (r = ?.09, p = .032). Contrary to our hypotheses, WBCs and AIs did not differ in reported stigma nor did we detect differences in its psychosocial impact. Stigma exerts a deleterious psychosocial impact on head and neck cancer survivors. It did not differ significantly between AI and WBC survivors.