Psychobiological Factors Predicting the Course of Breast Cancer

Drawing on a carefully controlled sample of 52 women with a history of breast carcinoma and 34 healthy controls, this prospective study examined empirical associations between psychological factors and the progression of neoplastic disorders over a follow-up period averaging 624 days. Psychological variables were psychometrically assessed by self-report measures. A multiple regression analysis which controlled for disease stage at original diagnosis, age, total length of disease course, hematological factors, and blood chemistries measured at study onset showed neoplastic spread to be associated with a repressive personality style, reduced expression of negative affect, helplessness-hopelessness, chronic stress, and comforting daydreaming. The identified model of medical and psychological variables accounted for 56% of the observed variance. A psychobiological model of brain-body disregulation provided the best account of the observed associations between psychological functioning and the progression of disease. Future research is necessary to examine the role which psychological functioning may exert upon health-relevant behaviors that might blunt the benefits of professional health care.     

Bullying at work: a discussion of definitions and prevalence, based on an empirical study

The past 15 years have witnessed a growing interest in studies of bullying in the area of work and organizational psychology, but the results of research on this topic seem to indicate very wide variations in the prevalence of bullying. The range of differences may be primarily due to the utilization of different categories and operationalizations of the concept. The aim of this study is to discuss definitions and delimitations of the phenomenon known as bullying, and to demonstrate empirically how the prevalence of bullying can be determined by the way in which it is defined and delimited. On the background of a discussion of some current definitions of bullying and a survey of some central research results on its rate of occurrence, this study presents the results of a study of 3,024 public-sector employees. The results showed that 1.0% of the sample reported that they had been bullied weekly during the previous six months, while 4.7% reported themselves as having been exposed to acts of bullying with the same frequency and for the same period of time. If we change the criteria from "weekly" to "2-3 times a month" the prevalences rise to 3.7% and 26.9%. Based on observations of bullying the prevalence is 3.3%. The results are discussed with reference to other studies that are comparable in terms of delimitations and rates of occurrence and it is concluded that the prevalence is at the same level as these.     

Development and Psychometric Evaluation of an Item Bank for Computerized Adaptive Testing of the EORTC Insomnia Dimension in Cancer Patients (EORTC CAT-SL)

To further advance assessment of patient-reported outcomes, the European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group has developed computerized adaptive test (CAT) versions of all EORTC Quality of Life Core Questionnaire (QLQ-C30) scales/items. The aim of this study was to develop and evaluate an item bank for CAT measurement of insomnia (CAT-SL). In line with the EORTC guidelines, the developmental process comprised four phases: (I) defining the concept insomnia and literature search, (II) selection and formulation of new items, (III) pre-testing and (IV) field-testing, including psychometric analyses of the final item bank. In phase I, the literature search identified 155 items that were compatible with our conceptualisation of insomnia, including both quantity and quality of sleep. In phase II, following a multistep-approach, this number was reduced to 15 candidate items. Pre-testing of these items in cancer patients (phase III) resulted in an item list of 14 items, which were field-tested among 1094 patients in phase IV. Psychometric evaluations showed that eight items could be retained in a unidimensional model. The final item bank yielded greater measurement precision than the original QLQ-C30 insomnia item. It was estimated that administering two or more items from the insomnia item bank with CAT results in a saving in sample size between approximately 15–25%. The 8-item EORTC CAT-SL item bank facilitates precise and efficient measurement of insomnia as part of the EORTC CAT system of health-related quality life assessment in both clinical research and practice.

     

Spinoza: une lecture d'Aristote

Does (affirmative) judgement have a logical dual, negative judgement? Whether there is such a logical dualism was hotly debated at the beginning of the twentieth century. Frege argued in ‘Negation’ (1918/9) that logic can dispense with negative judgement. Frege's arguments shaped the views of later generations of analytic philosophers, but they will not have convinced such opponents as Brentano or Windelband. These philosophers believed in negative judgement for psychological, not logical, reasons. Reinach's ‘On the Theory of Negative Judgement’ (1911) spoke to the concerns of these philosophers. While Frege took the distinction between affirmative and negative judgement to be logically redundant, Reinach argued that it is the result of confusing judgement with a different mental act. In this article, I present Reinach's arguments against the ‘old logical dualism’ in context, analyse them and discuss Reinach's innovative use of the notion of focus in the theory of judgement. Recently, there has been a revival of the view that sentential negation is grounded in a prior mental act of rejection. In the final section, I argue that Reinach's analysis of rejection poses a challenge for the revivalists.     

The effect of low social support on short-term prognosis in patients following a first myocardial infarction

The objectives of the current study were (1) to assess adjustment in patients following a first myocardial infarction (MI) at 9 months compared with 4-6 weeks post-MI, (2) to examine the availability of and satisfaction with social support over time, and (3) to determine separate baseline psychosocial predictors of recurrent cardiac events. A questionnaire assessing post-traumatic stress disorder, anxiety, depression, health complaints, and social support, was distributed to consecutive patients 4-6 weeks and 9 months post-MI. Prior to assessment at follow-up, 8 (7%) of 112 patients had dropped out, and two had died due to cardiac causes. Objective clinical measures were obtained from medical records. There was an improvement in somatic and cognitive symptoms at follow-up, but no change in symptoms of arousal, depression, and anxiety. Half of the patients were afraid of a recurrent MI. There was a significant decrease in social support between baseline and follow-up, and lower social support at baseline was associated with a 10% increased risk of recurrent cardiac events at follow-up (OR: 0.90; 95% CI: 0.84 to 0.97) adjusting for all other variables. Some patients still experienced difficulties with psychosocial adjustment 9 months post-MI despite a reduction in somatic and cognitive symptoms. Social support decreased over time, which may have serious prognostic implications; lower social support at baseline was an independent predictor of recurrent events at 9 months. An important step for future research will be to investigate how social support can be enhanced in patients at risk.