Illness representations and distress in women undergoing screening for familial ovarian cancer

Women with a familial or genetic predisposition to ovarian cancer are at significantly increased risk of developing the disease, and this warrants effective risk management strategies. A clinical trial of ovarian cancer screening (OCS) is being conducted to establish the effectiveness of this risk management strategy. This article reports data from its psychological partner study which aims to evaluate the psychological effects of OCS. Leventhal's Self-Regulatory Model provided the theoretical framework for understanding emotional responses to OCS. The revised Illness Perceptions Questionnaire (IPQ-R) is based on this model and the IPQ-R, adapted to the risk of ovarian cancer, was completed by women (N?=?1999) prior to screening. The original IPQ-R factor structure was not replicated but IPQ-R variables explained 14.70% of the variance in women's ovarian cancer-specific distress after controlling for age, general anxiety and depression. Negative emotional representations of ovarian cancer risk and general anxiety were moderately associated with greater ovarian cancer-specific distress whereas cognitive illness representations were weakly related to ovarian cancer-specific distress. Further analyses of data from the ongoing psychological evaluation are needed to determine the predictive utility of IPQ-R variables in explaining distress during OCS.     

Randomised trial of expressive writing for distressed metastatic breast cancer patients

Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?<?0.05). Findings suggest that expressive writing may improve the uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention.     

The moderating role of distress tolerance in the association between anxiety sensitivity physical concerns and panic and PTSD-related re-experiencing symptoms

Abstract

The present investigation evaluated the moderating role of distress tolerance (DT) in the relation between the physical concerns (PC) dimension of anxiety sensitivity (AS–PC) and panic and posttraumatic stress disorder (PTSD)-related re-experiencing symptoms in a nonclinical, undergraduate sample (n = 416; 300 females; M _age=20.3 years, SD = 4.8). Consistent with prediction, there was a significant interactive effect between AS–PC and DT in regard to panic symptoms, such that greater AS–PC and low DT was associated with greater panic symptoms after controlling for the variance accounted for by negative affectivity and the respective main effects. However, contrary to prediction, AS–PC and DT did not significantly interact to predict PTSD-related re-experiencing symptoms. Also consistent with prediction, there was no interactive effect apparent for symptoms of depression or general anxiety, suggesting that the interaction between AS–PC and DT is specific to panic psychopathology.     

Development of the Trauma Appraisal Questionnaire

This study describes the development and psychometric properties of the Trauma Appraisal Questionnaire (TAQ). Items were generated based on interviews with 72 ethnically diverse community participants exposed to a range of trauma types. From the interviews, more than 600 items that tapped beliefs, emotions, and behaviors were generated for 9 appraisal categories (e.g., fear, betrayal, shame). Based on expert feedback, 108 items were retained for initial testing in a sample of 714 undergraduate volunteers. Using a factor analytic strategy, we arrived at a 6-scale, 54-item solution. The reliability and validity of the new measure were evaluated in community (N = 119) and undergraduate (Ns = 139 and 79) samples. The measure demonstrated excellent reliability (test–retest and internal consistency) and validity (convergent, discriminant, and concurrent).     

Effects of Gender,Ethnicity and Educational Status on Exposure to Community Violence and Psychological Distress in Adolescence

ABSTRACT

A study of 1,142 older adolescents living in the central city of a large urban area found a complex set of relationships among exposure to community violence, psychological distress, gender, ethnicity, and educational status. Although males and school dropouts had higher levels of exposure and females had higher levels of psychological distress, the relationshipbetween exposure to community violence and psychological distress did not differ by gender, ethnicity or educational status. The findings are interpreted in terms of the theory of protective and vulnerability processes. The authors conclude that the relationship between exposure to community violence and psychological distress is robust.     

La gestion de la souffrance par le psychologue clinicien. Étude des impacts et des stratégies de coping

We focus in this study on strategies used by clinical psychologists to cope with their own or patient psychological distress in the framework of help relationship. A self-administered form was sent to listings of professionals by e-mail. The sample is made of 187 French clinical psychologists. To cope with patients’ suffering, psychologists use mostly avoidance coping style. And the strategies they prefer are “supervision”, “personal therapy” and “speaking with colleagues” (problem focused coping strategies). To cope with their own distress, which has a lot of negative impacts on help relationship, psychologists have most frequently a problem focused coping style but their favourite strategy is to “lighten their schedules”. And almost a quarter of the sample presents a significant level of distress. In conclusion, results show that psychological distress management by psychologists is an important question with a lot of ethical questions.     

Sources of “relational homes”: a qualitative study of cancer survivors’ perceptions of emotional support

The aim of this article is to shed light on the different ways in which a group of Danish cancer survivors fulfil their need of emotional support. The study comprised participant observation at a Danish cancer rehabilitation centre, individual semi-structured interviews and focus group interviews with course participants. The analytical process combined the inductive approach of interpretative phenomenological analysis with a deductive theoretical strategy. Key concepts from Robert D. Stolorow's existential-phenomenological trauma theory were used as interpretative framework. Findings suggest that cancer survivors’ perception of emotional support is captured by the theoretical concept a “relational home,” understood here as a supportive and caring environment. A relational home may include different dimensions in various situations and contexts, including an existential and metaphysical dimension in which God/a higher power may provide emotional support similar to that obtained in human relationships.     

Distress Tolerance and Anxiety Sensitivity Cognitive Concerns: Testing the Incremental Contributions of Affect Dysregulation Constructs on Suicidal Ideation and Suicide Attempt

Empirical work has suggested relationships among suicide-related outcomes and several constructs related to affect dysregulation, notably anxiety sensitivity (AS) and distress tolerance (DT). However, important questions remain, including the relative contributions of these affect regulation variables as well as the direct contribution of DT on suicidal ideation and prior attempts. The current study sought to better elucidate the nature of these relationships by examining AS, DT, and suicidal ideation and attempt in a clinical sample (N = 192). Consistent with prior work and prediction, findings revealed a significant relationship between the AS cognitive concerns subfactor and suicidal ideation and suicide attempt history after accounting for the effects of DT, gender, and depressive symptoms. In addition, depressive symptoms significantly moderated the relationship between the AS cognitive concerns subfactor and suicidal ideation. After accounting for the influence of AS, analyses revealed that DT approached significance in predicting suicidal ideation, but did not significantly predict suicide attempt history. These results suggest that elevated AS cognitive concerns are particularly relevant to suicide in the context of depressive symptoms. Clinicians may benefit from implementing AS reduction strategies with individuals who endorse elevated suicide risk as well as elevated AS cognitive concerns.     

Differential Associations Between Perceived and Objective Measurement of Distress Tolerance in Relation to Antiretroviral Treatment Adherence and Response Among HIV-Positive Individuals

The present study sought to extend prior work, showing an association between self-reported distress tolerance and self-reported antiretroviral treatment (ART) adherence, by conducting a multimethod test of the association between distress tolerance and objective measures of ART adherence among a sample of 140 individuals (23.6% female) with human immunodeficiency virus (HIV). Findings indicated that, after accounting for negative affectivity and ART side-effect severity, distress tolerance was significantly associated with pill count adherence as well as viral load. Specifically, a differential association was observed whereby self-reported distress tolerance was associated with pill count adherence, whereas behavioral distress tolerance was associated with viral load. Importantly, no associations were observed between either measure of distress tolerance and CD4 count. Findings are discussed in terms of the importance of both behavioral and perceived distress tolerance assessment among patients with HIV as well as potential clinical implications related to the integration of distress tolerance-focused treatments into existing interventions for individuals with HIV.     

The Social Intelligence of Acting Students

American acting students were asked to predict the ratings made by the general population of undergraduate psychology students on an adjective checklist dealing with several professions, one of which was acting. The same task was set for two benchmark comparison groups (psychology graduate students and a sample from the general population of students). Chi-square comparisons of the ratings of the undergraduate psychology students and their predicted ratings by the acting students revealed that the acting students achieved a 70% correct prediction rate. Chi-square analyses of the performance of the psychology graduate students and the general student sample showed that the acting students' predictions were inferior to those of the psychology graduate students but no different from those of the general undergraduate student sample. The acting students were more accurate in predicting the endorsement of negative adjectives (100%) than positive adjectives (55%). The acting students tended to distrust other people's attitudes towards actors, whereas, in fact, the general population of students' feelings about them were mildly positive.