Do perceptions of vulnerability and worry mediate the effects of a smoking cessation intervention for women attending for a routine cervical smear test? An experimental study.

Objective: Numerous correlational studies have examined whether perceptions of vulnerability or worry are better predictors of health-related behavior. The aim of this experimental study was to explore some of the potential causal relationships involved: Are the effects of a brief smoking cessation intervention (for women attending for cervical smear tests) on intention to stop smoking mediated by perceived vulnerability or worry about cervical cancer? Design: A mediation analysis of an experimental study. Main outcome measures: Perceived vulnerability to and worry about cervical cancer, and intention to stop smoking in the next month. Results: Questionnaires were completed by 172 (71%) women at 2-week follow-up. Compared with women in the control group, those in the intervention group had higher perceptions of vulnerability, worry, and intention to stop smoking. Personal vulnerability (p Conclusion: Worry may be a less important construct in relation to disease prevention behaviors such as smoking cessation. More experimental studies comparing different behaviors are needed to determine the causal relationship between worry and outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

Objective: The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. Design: Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. Main Outcome Measures: The primary outcome measures for this study were psychological distress and psychological well-being. Results: Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. Conclusion: The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: A growth mixture modeling approach.

Objective: This study investigated trajectories of psychological distress and their relationships with change in psychosocial resources in the year following cancer diagnosis. Design: Chinese colorectal cancer (CRC) patients (n = 234) were assessed within 12 weeks of diagnosis (T1) and again at 3-month (T2) and 12-month (T3) follow-ups. Growth mixture modeling was used to analyze the longitudinal data. Main Outcome Measures: Psychological distress was measured at the three time-points using Hospital Anxiety and Depression Scale (HADS). Results: Growth mixture models identified four classes: chronic distress (7–9%), delayed distress (10–13%), recovery (13–16%), and resilient (65–67%). People in chronic distress were more likely to demonstrate loss in physical functioning and social relational quality than those in delayed distress, and loss in physical functioning, optimism, and hope than those in recovery, but more likely to demonstrate stability/gain in optimistic personalities than those in delayed distress and resilient. People in resilient were more likely to report stability/gain in optimistic personalities than those in delayed distress but not those in recovery. Conclusion: Understanding differential outcome trajectories and associated change in coping resources has implications for developing ongoing psychological services for cancer patients during the diagnosis and treatment process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of stress autonomy versus stress sensitization in adolescents at varied risk for depression.

This longitudinal study investigated the stress autonomy, stress sensitization, and depression vulnerability hypotheses in adolescents across 6 years (i.e., Grades 6 through 12). Participants were 240 children (Time 1 mean age = 11.86, SD = 0.57) who varied in risk for depression on the basis of their mother's history of mood disorders. All analyses were conducted as multilevel models to account for nesting in the data. Results were consistent with the stress sensitization hypothesis. The within-subject relation of stress levels to depressive symptoms strengthened with increasing numbers of prior depressive episodes. In addition, evidence consistent with the vulnerability hypothesis was found. The relation of stress levels to depressive symptoms was stronger for adolescents who were at risk for depression on the basis of maternal depression history and for those who had experienced more depressive episodes through Grade 12. These findings suggest that onsets of depression in adolescents may be predicted by both relatively stable and dynamic transactions between stressful life events and vulnerabilities such as maternal depression and youths' own history of depressive episodes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Response to Test Results in an Ovarian Cancer Screening Program: A Prospective, Longitudinal Study.

To identify the psychological impact of receipt of an abnormal yet benign screening test result, the authors examined the response to a transvaginal ultrasound screening (TVS) test for ovarian cancer (OC) in asymptomatic women (N=540) undergoing an initial TVS screening test. Interviews were conducted prior to undergoing TVS screening and at 2 weeks and 4 months following this baseline. Women receiving an abnormal yet benign TVS test result (n=33) reported elevated OC-specific, but not general, distress at 2-week follow-up. Distress returned to baseline levels at 4-month follow-up. Consistent with the monitoring process and cognitive-social health information processing models, response to an abnormal TVS result was moderated by a monitoring coping style, low optimism, and a family history of OC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in risk perceptions in relation to self-reported colorectal cancer screening among first-degree relatives of colorectal cancer cases enrolled in a randomized trial.

Objective: This secondary data analysis was conducted to evaluate the applicability of the Risk Reappraisal Hypothesis, which has been proposed to explain the influence of performing a health behavior on perceived risk. Data were collected in the context of a randomized trial, which found that an individually tailored, multicomponent intervention was successful in increasing colorectal cancer (CRC) screening among first-degree relatives of CRC cases. Method: The ethnically diverse study sample (N = 841; 29% Latino, 21% African American, 20% Asian) consisted of adult siblings and children (40–80 years) of CRC cases, identified through the California Cancer Registry. Data were collected at baseline and at 6- and 12-month follow-up. Changes in self-reported risk perception (perceived likelihood of developing CRC) were examined over the study period in relation to study condition and screening status. Results: Greater increases in perceived risk were observed among intervention versus control-group participants over the study period, but increases were limited to intervention participants who had not been screened. We also examined trajectories of perceived risk in relation to timing of screening receipt (e.g., before 6 months, 6–12 months, never). Continued upward shifts in risk were observed during the study period among intervention participants not screened during the study. In contrast, participants screened by 6 months displayed a reduction or leveling off in perceived risk between 6- and 12-month follow-up. Conclusion: Results provide support for the applicability of the Risk Reappraisal Hypothesis within a high-risk sample enrolled in a CRC screening promotion trial. Future research is needed to explore the impact of short-term risk reductions on future CRC screening behavior. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Relative Importance of Three Domains of Positive and Negative Social Exchanges: A Longitudinal Model With Comparable Measures.

Researchers have expressed considerable interest in the question of whether positive or negative social exchanges more strongly affect psychological health, but previous studies have been limited by using nonparallel measures of positive and negative social exchanges, by measuring negative affect only, and by relying largely on cross-sectional designs. The independent effects of positive and negative exchanges on both positive and negative affect were examined in a short-term longitudinal study of 277 older adults, using social exchange measures with parallel content and equivalent reliability and validity. In cross-sectional analyses, positive exchanges predicted positive affect, and negative exchanges predicted negative affect. In longitudinal analyses, however, negative exchanges predicted both positive and negative affect, whereas positive exchanges were unrelated to either outcome. The more potent and longer-lasting effects of negative exchanges have important implications for theory and interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

William A. Hunt (1903–1986).

William A. Hunt was one of our country's early scientist-clinicians. He began his career with study of a psychology that was a meld of Titchener's structuralism and Harvard's functionalism and completed it 50 years later in the field of health psychology. Hunt spent all but a few of those 50 years as a full-time teacher, at schools that included Dartmouth College, Connecticut College for Women, and Northwestern University. While doing his dissertation, he had mastered and used the structuralist's experimental method of introspection, applying it to the study of human emotion, specifically the James-Lange theory. In 1941, Hunt entered the Navy. He discerned that the screening for military duty of some 15 million women and men required an approach suited to the rapid, albeit individual, screening of large numbers of such personnel. His teaming up with a psychiatrist, Cecil Wittson, led to their joint development of a screening interview lasting one to two minutes that, with continued refinement, proved remarkably effective. Their goals as the mental health specialists participating in the medical examination conducted at this intake station were twofold: (a) to improve the efficiency of the Navy by removing those neuropsychiatric high-risk recruits who were potential psychiatric casualties if they continued in the Navy and (b) by such removal, to save these recruits the disastrous personal experience of subsequent breakdown during military duty. In his own still active research in the 1960s and 1970s Hunt continued to apply the same methods he earlier had used (in his Navy research) to the judgmental processes clinical psychologists used to identify psychological test responses that were pathognomonic of schizophrenia, mental retardation, and related forms of psychopathology. Hunt remained, until his death at age 82, an active scientist-clinician. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping and communication-enhancing intervention versus supportive counseling for women diagnosed with gynecological cancers.

This study compared the efficacy of 2 psychological interventions, a coping and communication-enhancing intervention (CCI) and supportive counseling (SC), in reducing depressive symptoms and cancer-specific distress of women diagnosed with gynecological cancer. Demographic, medical, and psychological moderators of intervention effects were evaluated. Three hundred fifty-three women with gynecological cancer were randomly assigned to 7 sessions of CCI, 7 sessions of SC, or usual care. Intent-to-treat growth curve analyses indicated that participants assigned to CCI and SC reported lower depressive symptoms than participants assigned to usual care at the 6- and 9-month follow-ups. Women with greater than average increases in physician-rated physical symptoms and/or women who were more expressive of positive emotions benefited more from SC than women with lower than average increases in symptom scores and/or women who were less expressive of positive emotions. These findings suggest that both interventions may be effective in treating depressive symptoms among patients with gynecological cancer. Future research should evaluate whether bolstering both psychological interventions with additional intervention sessions and topics in the disease trajectory will result in persistent long-term effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What is the relationship between breast cancer risk and mammography screening? A meta-analytic review.

This meta-analytic review addresses the issue of how a woman's risk of breast cancer relates to the likelihood that she will obtain mammography screenings. Studies that compared women with or without a family history of breast cancer (n?=?19) showed that women with a family history were more likely to have been screened. Studies that measured perceived risk (n?=?19) showed that feeling vulnerable to breast cancer was positively related to having obtained a screening. Studies that compared women who did or did not have a history of breast problems (n?=?10) showed that those with a positive history were more likely to have been screened. Finally, studies that measured worry (n?=?6) showed that greater worry was related to higher screening levels. Taken together, these data suggest that increasing perceptions of personal vulnerability may increase screening behavior for breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The pros and cons of laser dacryocystorhinostomy

Sixty-one patients participated in a longitudinal study designed to compare the psychological effects of osseointegrated implants with those of conventional denture replacements. Thirty-two patients who requested either relining or reconstruction of their dentures were asked to complete questionnaires designed to measure their psychological well-being while they were on a waiting list and then again 6 months after treatment. Their responses were compared with those of 29 patients who had received an osseointegrated implant. While the implant patients had reported significant declines in psychological distress, there was no such change for the denture patients. Although both groups experienced fewer disabling symptoms, the decline was greater for the implant group. Finally, neither group showed evidence of any change in self-esteem. The results suggest that osseointegrated implants can have a more positive effect on well-being than denture replacements.     

The Relationship Between Witnessing Parental Conflict During Childhood and Later Psychological Adjustment Among University Students: Disentangling Confounding Risk Factors.

The purpose of the current study was to examine in detail the association between witnessing domestic violence (DV) and long-term psychological adjustment. Important limitations of past research were addressed, including controlling for several associated risk factors. Special attention was paid to whether the perpetrator of the violence was the maternal or paternal figure, as well as to whether the witness to the violence was male or female. Participants completed measures examining DV witnessed, direct child abuse experienced, and current psychopathology. Following screening for physical and sexual abuse, a sample of 351 individuals was selected. Four groups of participants were compared. Results indicated that individuals who had witnessed either physical DV or major psychological DV had higher levels of psychopathology than individuals who reported witnessing minor psychological DV or controls. After controlling for direct psychological abuse experienced, witnessing DV remained a significant predictor of psychopathology for males but not for females. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conjunctive moderator variables in vulnerability and resiliency research: Life stress, social support and coping skills, and adolescent sport injuries.

In life event research relating to vulnerability and resilience factors, single moderator variables have typically been the focus of study. Little is known about the ways in which moderator variables may interact with one another to increase vulnerability or resilience. We propose a distinction between conjunctive moderation, in which multiple moderators must co-occur in a specific combination or pattern to maximize a relation between a predictor and an outcome variable, and disjunctive moderation, in which any one of a number of moderators maximizes the predictor–criterion relation. Our results indicate that social support and psychological coping skills are statistically independent psychosocial resources and that they operate in a conjunctive manner to influence the relation between life stress and subsequent athletic injury in adolescents. Only athletes low in both coping skills and social support exhibited a significant stress–injury relation, and in that vulnerable subgroup, negative major life events accounted for up to 30% of the injury variance. Methodological considerations in the assessment of conjunctive moderator effects are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do women who undergo further investigation for breast screening suffer adverse psychological consequences? A multi-centre follow-up study comparing different breast screening result groups five months after their last breast screening appointment

BACKGROUND: In 1995-1996 about 53500 women aged 50-64 attending for routine breast screening were called back for further investigation after an initial mammogram. Even when women were found to be clear after further investigation, significant adverse psychological consequences (PCs) can remain one month later. This follow-up study investigates whether residual emotional effects persisted five months after women received a clear result. METHODS: Women who had previously completed a questionnaire one month after their last breast screening appointment, at which they had a clear result, were invited to complete a further postal questionnaire four months later (five months after their last appointment). We compare women who received a clear result after assessment without fine needle aspiration cytology (FNAC), after assessment with FNAC, after a benign biopsy, and those who had been placed on early recall, with those who received a clear result after mammography (reference group). RESULTS: The response rate was 76 per cent (215/284). All groups of women who went on for further investigation suffered significantly greater adverse psychological consequences (PCs) at five months than women who were given a clear result after mammography. Compared with 10 per cent (5/52) of women who received a clear result after a basic mammogram, adverse psychological consequences were experienced by 59 per cent (27/46, p<0.00001) of the women who were placed on six month early recall, 61 per cent (14/23, p<0.0001) of women who had benign surgical biopsy, 44 per cent (18/41, p<0.0001) of women who received a clear result after assessment (with FNAC), and 45 per cent (23/51, p<0.0001) of women who received a clear result after assessment (without FNAC). Whereas all groups who had gone on for further investigations had experienced a significant decrease in PCs between one month and five months, those who were placed on six month early recall showed no significant difference in PCs between these two time periods. Other factors relating to adverse experiences as a result of breast screening are reported. CONCLUSION: Despite receiving a clear final result, women who undergo further investigation suffer significantly greater adverse psychological consequences five months after their last screening appointment than women who receive a clear result after mammography.     

Does pretreatment severity moderate the efficacy of psychological treatment of adult outpatient depression? A meta-analysis.

Objective: It is widely believed that psychological treatment has little effect on more severely depressed patients. This study assessed whether pretreatment severity moderates psychological treatment outcome relative to controls by means of meta-analyses. Method: We included 132 studies (10,134 participants) from a database of studies (www.evidencebasedpsychotherapies.org) in which the effects of psychological treatment on adult outpatients with a depressive disorder or an elevated level of depressive symptoms were compared with a control condition in a randomized controlled trial. Two raters independently extracted outcome data and rated study characteristics. We conducted metaregression analyses assessing whether mean pretreatment depression scores predicted psychological treatment versus control condition posttreatment effect size and subgroup analyses summarizing the results of studies reporting within-study analyses of depression severity and psychological treatment outcome. Results: Psychological treatment was found to be consistently superior to control conditions (d = 0.40–0.88). We found no indication that pretreatment mean depression scores predicted psychological treatment versus control condition posttreatment effect size, even after adjusting for relevant study characteristics. However, among the smaller subset of studies that reported within-study severity analyses, posttreatment effect sizes were higher for high-severity patients (d = 0.63) than for low-severity patients (d = 0.22) when psychological treatment was efficacious relative to a more stringent control. Conclusion: Contrary to conventional wisdom, our findings suggest that when compared with control conditions, psychological treatment might be more efficacious for high-severity than for low-severity patients. Because the number of studies reporting within-study severity analyses is small, we recommend that future studies routinely report tests for Severity × Treatment interactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distress tolerance and duration of past smoking cessation attempts.

The present study tested the hypothesis that limited ability to tolerate physical and psychological distress is associated with early relapse from smoking cessation. Specifically, the authors exposed 16 current smokers who had failed to sustain any previous quit attempt for more than 24 hr (immediate relapsers) and 16 smokers with at least 1 sustained quit attempt of 3 months or longer (delayed relapsers) to psychological (mental arithmetic) and physical (carbon dioxide inhalation-breath holding) stressors. Relative to delayed relapsers, immediate relapsers were characterized by higher baseline levels of affective vulnerability, by greater levels of dysphoria and urge to smoke after 12 hr of nicotine deprivation, and by less task persistence on the stressors, suggesting that these may be risk factors for early lapse in the context of quitting smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological changes in children with cancer: the treatment of missing data in longitudinal studies

Researchers conducting longitudinal studies with children or adults are inevitably confronted with problems of attrition and missing data. Missing data in longitudinal studies is frequently handled by excluding from analyses those cases for whom data are incomplete. This approach to missing data is not optimal. On the one hand, if data are missing at random, then dropping incomplete cases ignores information collected on those cases that could be used to improve estimates of population parameters (e.g., means, variances, covariances, and growth rates) and improve the power of significance tests of statistical hypotheses. On the other hand, if data are not missing at random, then dropping incomplete cases leads to biased parameter estimates and hypothesis tests that may be internally and externally invalid. This study uses three years of follow-up data from a longitudinal investigation of neuropsychological outcomes of cancer in children to demonstrate the problems presented by missing data in repeated measures designs and some solutions. In evaluating potential biasing effects of attrition, the study extends previous research on neuropsychological outcomes in pediatric cancer by inclusion of patients whose disease had relapsed, and by comparison of surviving and nonsurviving patients. Although the data presented have specific relevance to the study of neuropsychological outcome in pediatric cancer, the problems of missing data and the solutions presented are relevant to a wide variety of diseases and conditions of interest to researchers in child and adult neuropsychology.     

Transcranial magnetic-stimulation mapping of the cortical topography of the human masseter muscle

BACKGROUND: Population-based screening for prostate cancer is currently being evaluated in randomized clinical trials in the United States and in Europe. Side effects arising from the process of screening and from the earlier treatment of screen-detected prostate cancer may be important factors in the evaluation. To examine health-related quality of life (or health status) among men screened for prostate cancer, we conducted a longitudinal study of 626 attenders to the Rotterdam (The Netherlands) prostate cancer screening program and of 500 nonparticipants. METHODS: Attenders of the screening program and nonparticipants completed self-assessment questionnaires (SF-36 [i.e., Medical Outcomes Study 36-Item Short-Form Health Survey] and EQ-5D [i.e., EuroQol measure for health-related quality of life] health surveys) to measure generic health status, as well as an additional questionnaire for anxiety and items relating to prostate cancer screening. RESULTS: Physical discomfort during digital rectal examination and during transrectal ultrasound was reported by 181 (37%) of 491 men and by 139 (29%) of 487 men, respectively; discomfort during prostate biopsy was reported by 64 (55%) of 116 men. Mean scores for health status and anxiety indicated that the participants did not experience relevant changes in physical, psychological, and social functioning during the screening procedure. However, high levels of anxiety were observed throughout the screening process among men with a high predisposition to anxiety. Similar scores for anxiety predisposition were observed among attenders and nonparticipants. CONCLUSIONS: At the group level, we did not find evidence that prostate cancer screening induced important short-term health-status effects, despite the short-lasting side effects related to the biopsy procedure. However, subgroups may experience high levels of anxiety. The implication is that unfavorable health-status effects of prostate cancer screening occur mainly in the treatment phase.