A survey of smoking status and cancer risk perceptions among participants attending a hospital-based head and neck screening program

Abstract

Screening for head and neck cancer is underutilized. Given that lack of knowledge of the risk factors may partially account for screening underutilization. we surveyed subjective risk and knowledge of risk factors for head and neck cancer among 124 individuals who attended a free. hospital-based head and neck cancer screening. Few participants were current smokers. Most attendees perceived their risk as similar to others of their age and sex. Personal health habits comprised almost all of the risk-decreasing factors, yet less than half of the risk-increasing factors. generated. Personal habits were less frequently endorsed than factors such as pollution and heredity. Those who mentioned a risk behavior, or a family cancer history, reported higher subjective risk. Those who mentioned a personal health habit reported lower subjective risk. Results highlight needed efforts to increase screening among high-risk individuals through targeted education messages.     

Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study

Abstract

Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factor in the transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they arc associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidme and cabstrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5. but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early pint in the development of pain and associated activity problems in people with back pain. Theoretically. our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.     

Lifestyle changes are related to reductions in depression in persons with elevated coronary risk factors

This observational study investigates whether persons with elevated coronary risk factors (CRFs >3 and/or diabetes) and depression [i.e., ≥16 on the Center for Epidemiological Scale – Depression (CES-D)] can make changes in health behaviours over 3 months and improve depressive symptoms and other CRFs. Analyses were based on data from 310 men and 687 women enrolled in the high-risk arm of the Multisite Cardiac Lifestyle Intervention Program, targeting diet (10% fat), exercise (3 h per week) and stress management (7 h per week). As expected, at study entry, depressed persons had a more adverse medical status, consumed more dietary fat and practiced less stress management than non-depressed persons. To examine 3-month changes, participants were grouped into (1) depressed persons who became non-depressed (CES-D ≤ 16, n = 248; 73%), (2) persons who remained or became depressed (CES-D >16, n = 76) and (3) non-depressed persons who remained non-depressed (n = 597). All persons, regardless of group, met program goals. The greatest improvements (i.e., diet, exercise, perceived stress, hostility and mental health) were observed in Group 1 relative to Groups 2 and 3, which did not differ from each other. Comprehensive lifestyle changes appear to be feasible and beneficial for initially depressed persons with elevated CRFs.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Illness perceptions and distress in women at increased risk of breast cancer

Variation in the levels of distress in women at increased risk of breast cancer has been reported, yet there is limited understanding of the factors that are associated with heightened distress in this population. This study took a theoretical approach using Leventhal's Self Regulatory Model (SRM) to understand variation in distress levels. The study examined the associations between perceptions of breast cancer and distress in women at increased risk of breast cancer, and a comparison sample with no experience of the disease in their social environment. Questionnaire data from 117 women at increased risk of breast cancer and 100 comparison women were analysed. Women at increased risk of breast cancer showed comparable levels of general distress but significantly higher levels of cancer specific distress than the comparison group. There were few differences in illness perceptions between the samples, although a number of cognitive perceptions of breast cancer were related to both general and cancer specific distress in the increased risk sample, but not in the comparison sample. The results suggest that the SRM provides a useful framework to explore the psychological response to genetic risk. Further research is required in this population to examine illness perceptions in more detail, validate quantitative measures of illness perceptions, and examine interactions between risk perception and the SRM constructs.     

When the risks are low: the impact of absolute and comparative information on disturbance and understanding in US and UK samples

When Klein, W. M. gave participants absolute and comparative risk information (crossed experimentally) they were more disturbed by being above than below average, but not by being at higher rather than lower risk. The current experiment tests whether Klein's findings extend to situations involving lower risk figures more typical of genuine health risks, assesses participants’ understanding of the information, and directly compares responses of US and UK samples. Participants were presented with hypothetical information about comparative and absolute risks of deep vein thrombosis. There was a main effect of absolute risk information on disturbance and precaution intentions in the US sample, but no effects of comparative information on these measures in either sample. Understanding was poor among participants receiving both pieces of risk information. Future studies should include measures of understanding to establish whether people are failing to understand what they are told or failing to respond systematically to what they understand. Practically, the findings caution against providing comparative risk information when communicating low risk figures.     

Characterization of Children's Decision Making: Sensitivity to Punishment Frequency,Not Task Complexity

On a gambling task that models real-life decision making, children between ages 7 and 12 perform like patients with bilateral lesions of the ventromedial prefrontal cortex (VMPFC), opting for choices that yield high immediate gains in spite of higher future losses (Crone &; Van der Molen, 2004 Crone, E. A. and Van der Molen, M. W. 2004. Developmental changes in decision-making: Performance on a gambling task previously shown to rely on ventromedial prefrontal cortex. Developmental Neuropsychology, 25(3): 251–279. [PUBMED][INFOTRIEVE][CROSSREF][Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). The current study set out to characterize developmental changes in decision making by varying task complexity and punishment frequency. Three age groups (7–9 years, 10–12 years, 13–15 years) performed two versions of a computerized variant of the original Iowa gambling task. Task complexity was manipulated by varying the number of choices participants could make. Punishment frequency was manipulated by varying the frequency of delayed punishment. Results showed a developmental increase in the sensitivity to future consequences, which was present only when the punishment was presented infrequently. These results could not be explained by differential sensitivity to task complexity, hypersensitivity to reward, or failure to switch response set after receiving punishment. There was a general pattern of boys outperforming girls by making more advantageous choices over the course of the task. In conclusion, 7–12-year-old children—like VMPFC patients—appear myopic about the future except when the potential for future punishment is high.     

Social aspects of career choice from the perspective of habitus theory

The concept of habitus designates a cognitive structure that is socially embedded and can give valuable insight into the social influences on career choice. A study investigating the relationship of habitus to career choice is presented in a sample of Icelandic youth aged 19–22 (N = 476). Measures of habitus were developed on the basis of reported cultural and leisure activities. The analysis of leisure and cultural items progressed in two steps: factor analysis and cluster analysis. The clusters constitute the four different habitus groups: Pop and fashion, Sports and rock, Music, and Literature. Correspondence factor analysis showed that the habitus groups (clusters) were related to other social variables, such as gender and class; validating habitus theory. Additionally, habitus measures were strongly linked to career variables, such as occupational perception and preferred future occupation. The results support previous research in showing that habitus theory is relevant to career counseling theory and can be a basis of understanding the relationship between social structure and career choice.     

Social comparison influences on disciplinary panels: a brief qualitative study in Kenyan secondary schools

This study investigated the influences of social comparisons on group polarization in decision making among members of selected Kenyan secondary school disciplinary panels. Ten participants from 10 selected secondary school disciplinary panels were involved. Semi-structured interviews were used to collect qualitative data on the experiences of the participants regarding the influences of social comparisons on their decision-making behaviours during participation in their schools’ disciplinary hearing meetings. The results revealed that in the dynamic interactions among disciplinary panel members during disciplinary hearing meetings, the panel members engaged in social comparisons among themselves, leading to their shifts in decision-making behaviours in favour of consensus in group decisions or group polarization in decision making.