Optimistic Personality and Psychosocial Well-Being During Treatment Predict Psychosocial Well-Being Among Long-Term Survivors of Breast Cancer.

In considering well-being among survivors of life-threatening illnesses such as breast cancer, 2 important questions are whether there is continuity between initial adjustment and longer term adjustment and what role personality plays in long-term adjustment. In this research, a sample of 163 early stage breast cancer patients whose psychosocial adjustment was first assessed during the year after surgery completed the same measures 5-13 years after surgery. Initial reports of well-being were relatively strong predictors of follow-up well-being on the same measures. Initial optimism and marital status also predicted follow-up adjustment, even controlling for earlier adjustment, which exerted a substantial unique effect in multivariate analyses. In contrast, initial medical variables played virtually no predictive role. There is substantial continuity of subjective well-being across many years among survivors of breast cancer, rooted partly in personality and social connection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological health and problem-solving self-appraisal in older adults.

This study investigated relations between psychological health and problem-solving self-appraisal in 97 adults aged 65–96 years. Participants completed the Problem-Solving Inventory (P. P. Heppner, 1988) and two measures of psychological health encompassing both well-being and distress dimensions. Results of a canonical correlation analysis indicated that relations between problem-solving self-appraisal and psychological health were complex and sometimes contradictory. On the one hand, as problem-solving self-appraisal became more favorable (more confidence, more control, and increased approaching of problems), well-being increased and distress decreased. Conversely, perceptions of avoidant problem solving and decreased control were also associated with some increases in psychological health. Research and counseling implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interdependence in women with breast cancer and their partners: An interindividual model of distress.

Objective: The aim of this investigation was to test whether interdependence in dyads living with breast cancer could account for person–partner crossover effects in distress outcomes. Method: The sample consisted of 95 dyads with early-stage breast cancer. By using reciprocal dyadic data from women with breast cancer and their partners, we fit a structural equation model of the actor–partner interdependence model to examine the interaction of participants’ depression and stress in predicting their partner’s health outcomes. Results: Results revealed a pattern of influence whereby the interaction of high levels of depression coupled with high levels of stress in women with breast cancer was associated with lowered physical health and well-being in their partners. Although depression seemed to be the key mechanism in predicting distressing outcomes, when depression was combined with any additional stress, the level of physical distress was significantly greater. Results provided preliminary empirical support for crossover effects in the physical well-being of close relational partners in a cancer-related context. Further, results showed that distressing outcomes need not be limited to emotional distress but can also include physical distress. Conclusions: The findings from this study illustrate why it is not sufficient to concentrate care solely on the patient with cancer. Monitoring the social well-being of patients as they go through the cancer process could be as important as assessing their psychological state or other peripheral biomarkers. This line of inquiry would be advanced by including methods other than self-report in assessments of psychological and physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Survivors of childhood cancer and comparison peers: The influence of early family factors on distress in emerging adulthood.

This prospective study examines family predictors of distress among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. Children with cancer (n = 55), comparison peers (n = 60), and parents completed measures of distress, family environment, social support, and demographic characteristics during initial treatment, as well as follow-up measures of young adult distress and demographic characteristics soon after participants turned 18 years old. Severity of initial treatment and late effects were rated by healthcare providers for participants with cancer. For all participants, mother and father report of initial parent distress was associated with their report of young adult distress at follow-up. Young adult gender moderated this association. For survivors of childhood cancer, severity of initial treatment and late effects also moderated the association between parent and young adult distress. Improving parent distress may help reduce child distress in general. For survivors specifically, ameliorating the impact of initial treatment and long-term physical problems may be beneficial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conscientiousness predicts disease progression (CD4 number and viral load) in people living with HIV.

Objective: Psychosocial factors (e.g., depression, avoidant coping, life stress) have been related to disease progression in HIV. This study examined the relationship between the Big Five Conscientiousness factor and HIV disease progression (CD4 cell and viral load) over 1 year in 119 seropositive participants. The study also examined whether Conscientiousness effects were mediated by adherence, perceived stress, depression, or coping measures. Design: In a 1-year longitudinal design, participants completed the NEO Five-Factor Inventory Conscientiousness scale (P. T. Costa & R. R. McCrae, 1992). Participants also completed psychosocial assessments and underwent blood draws at initial assessments and 1-year follow-up. Main Outcome Measures: Multiple hierarchical regression models were used to predict change in CD4 cell numbers and viral load log 10, controlling for demographic variables, initial disease status, and antiretroviral medications. Results: Conscientiousness predicted significant increases in CD4 number and significant decreases in viral load at 1 year. Conscientiousness was related positively to medication adherence and active coping and negatively to depression and perceived stress. Only perceived stress emerged as a possible mediator. Conclusion: The significant relationship between Conscientiousness and medication adherence, distress, and coping suggests that an assessment of Conscientiousness in patients with HIV may help specify or target behavioral interventions to promote optimal disease management. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of psychological distress on absence from work.

The aims of this study were to examine the impact of psychological distress on absence from work; to compare psychological distress and job satisfaction as predictors of absence; and to compare the relative effects of 2 components of psychological distress, depression and anxiety, on absence. Organizational records of absence over a 3-year period were obtained for 323 health service staff in the United Kingdom, who also completed self-report measures of psychological distress and job satisfaction at the beginning of the study and 2 years later. Psychological distress, particularly depression, was found to predict absence, with higher levels of distress predicting a greater number of days and number of times absent. Job satisfaction and psychological distress independently predicted levels of absence. The psychological distress-absence relationship was not moderated by demographic variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Silver linings and candles in the dark: Differences among positive coping strategies in predicting subjective well-being.

Ideal coping strategies enhance positive aspects of well-being as well as reduce distress. Although researchers have identified several "positive coping" strategies, it is unclear which are most strongly associated with well-being or whether all strategies are equally appropriate for all kinds of stressors. Participants completed well-being measures, and described the most negative event of the day and their emotion regulation strategies for the next 7 days. Dispositional use of positive emotion-inducing coping strategies was most strongly associated with positive aspects of well-being. Use of positive coping did not decrease with increased objective stress during the week, and use of particular strategies was partly predicted by the types of stressors that were reported. Implications for theories of positive coping are discussed. (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)     

Posttraumatic growth following breast cancer: A controlled comparison study.

Cancer may be viewed as a psychosocial transition with the potential for positive and negative outcomes. This cross-sectional study (a) compared breast cancer (BC) survivors' (n?=?70) self-reports of depression, well-being, and posttraumatic growth with those of age- and education-matched healthy comparison women (n?=?70) and (b) identified correlates of posttraumatic growth among BC survivors. Groups did not differ in depression or well-being, but the BC group showed a pattern of greater posttraumatic growth, particularly in relating to others, appreciation of life, and spiritual change. BC participants' posttraumatic growth was unrelated to distress or well-being but was positively associated with perceived life-threat, prior talking about breast cancer, income, and time since diagnosis. Research that has focused solely on detection of distress and its correlates may paint an incomplete and potentially misleading picture of adjustment to cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical depression and weight change: A complex relation.

Based on previous research on the effects of emotional arousal on eating behavior, it was predicted that clinical depression would not result invariably in appetite suppression and weight loss. Normally restrained eaters were expected to show weight gain as a consequence of emotional distress, whereas normally unrestrained eaters were expected to show the traditionally predicted weight loss. Nine female and 3 male 21-44 yr old clinically depressed patients were designated as restrained or unrestrained eaters, and it was found that the former tended to gain weight (as indicated in self-reports) in conjunction with their depression while the latter tended to lose weight. It is concluded that weight changes bear a complex but systematic relation to emotional distress and well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional self-disclosure and emotional avoidance: Relations with symptoms of depression and anxiety.

Research suggests that individuals with heightened symptoms of mood and anxiety disorders engage in diminished emotional disclosure. On the basis of emotion regulation theories, the authors hypothesized that this symptom–disclosure relationship would be mediated by the avoidance of emotional experience and expression. In Study 1, college students (N = 831) completed measures of depression and anxiety symptoms, measures of tendencies to avoid emotional expression, and measures of tendencies to self-disclose distress. Structural equation modeling revealed that anhedonic depression and anxious arousal were associated with lessened emotional self-disclosure tendencies as mediated by avoidance of emotional expression. In Study 2, participants (N = 153) completed new measures of depression and anxiety symptoms, reflected on the most significant emotional event experienced during the past week, and rated their avoidance of emotion about the event and their self-disclosure of the event. Depression (but not anxiety) symptoms were negatively related to the disclosure of a specific event, but avoidance of emotional experience did not mediate this depression–disclosure relationship. These findings extend emotion dysregulation theory and suggest that depressive symptoms in particular are associated with reduced emotional disclosure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of distress to mood disturbance in primary care and psychiatric populations.

Disagreement remains as how to interpret elevated scores on measures of self-reported distress. This study compared elevated scores on the Center for Epidemiologic Studies-Depression Scale (CES-D) in 2 samples to mood disturbance as assessed in an interview. In a primary medical care sample, most distressed patients did not have a mood disturbance, and distress without mood disturbance was associated with little impairment. Primary care patients with elevated scores on the CES-D were less distressed and less likely to have mood disturbance, major depression, or impairment than distressed psychiatric patients. Few patients with mood disturbance in either sample failed to meet criteria for major depression. Implications are discussed for research on depression using self-report measures, for generalizations across clinical and nonclinical populations, and for screening for preventive interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sources of ethnic differences between Asian American and White American college students on measures of depression and social anxiety.

This study tested an affect-specific explanation for the Asian and White American differences in depression and social anxiety. Construal of the self as independent or interdependent in relation to others (H. R. Markus & S. Kitayama, see record 1991-23978-001) was hypothesized to be 1 possible way in which culture may be expressed in individuals' psychological functioning, which in turn was hypothesized to be linked specifically to social anxiety. College students (N?=?348; 183 White Americans and 165 Asian Americans) completed self-report measures of depression, social anxiety, and self-construals. Asian Americans scored significantly higher than White Americans on measures of depression and social anxiety. When the covariance between depression and social anxiety was statistically controlled, ethnicity and self-construal variables were found, as predicted, to be associated with measures of social anxiety but not depression. These findings suggest a more differentiated perspective on the relations between culture, ethnicity, and emotional distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial impact of illness intrusiveness moderated by self-concept and age in end-stage renal disease.

This study assesses whether a person's self-concept as a "chronic kidney patient" differentially moderates the psychosocial impact of illness intrusiveness—illness-induced lifestyle disruptions—across the life span. Renal transplant (n?=?52) and maintenance dialysis patients (n?=?49) completed the Illness Intrusiveness Ratings Scale, a semantic-differential self-concept measure, and structured interviews measuring psychosocial well-being and emotional distress. Across ages, distress rose with increasing illness intrusiveness when self-concept was similar, but not dissimilar, to the chronic kidney patient stereotype. The relation between illness intrusiveness and psychosocial well-being differed significantly between younger and older respondents depending on whether they construed themselves as similar versus dissimilar to the chronic kidney patient. Although self-definition moderates the psychosocial impact of chronic disease, this varies across the life span and across affect states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A phase model of psychotherapy outcome: Causal mediation of change.

A 3-phase model of psychotherapy outcome is proposed that entails progressive improvement of subjectively experienced well-being, reduction in symptomatology, and enhancement of life functioning. The model also predicts that movement into a later phase of treatment depends on whether progress has been made in an earlier phase. Thus, clinical improvement in subjective well-being potentiates symptomatic improvement, and clinical reduction in symptomatic distress potentiates symptomatic improvement. A large sample of psychotherapy patients provided self-reports of subjective well-being, symptomatic distress, and life functioning before beginning individual psychotherapy and after Sessions 2, 4, and 17 when possible. Changes in well-being, symptomatic distress, and life functioning means over this period were consistent with the 3-phase model. Measures of patient status on these 3 variables were converted into dichotomous improvement–nonimprovement scores between intake and each of Sessions 2, 4, and 17. An analysis of 2?×?2 cross-classification tables generated from these dichotomous measures suggested that improvement in well-being precedes and is a probabilistically necessary condition for reduction in symptomatic distress… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Flight Attendants' Daily Recovery From Work: Is There No Place Like Home?

This article builds on earlier work on recovery from work during off-job time and specifically addresses recovery in flight attendants, a group of employees whose work is characterized by a high degree of emotion work demands. Forty-seven flight attendants completed daily surveys on a total of 4 evenings when they stayed at home or when they stayed in a hotel. Multilevel analysis showed staying in a hotel did not impair well-being at bedtime. Spending time on work-related activities during off-job time decreased well-being, whereas spending time on physical activities (i.e., sports) and experiencing off-job time activities as recovery improved well-being, also when initial well-being immediately after work was controlled. Time spent on social activities increased depression during the evening. As a whole, this study largely confirms findings from previous research with other professional groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributional style and self-esteem; The prediction of emotional distress following a midterm exam.

A midterm design was used to determine whether students' attributional style for negative achievement events interacts with self-esteem and a lower-than-expected exam grade to predict changes in measures of specific and nonspecific depression and anxiety. Participants were 141 students who completed baseline measures of attributional style and self-esteem, as well as affective measures on several occasions before and after receipt of midterm grades. A pessimistic attributional style for negative events interacted with self-esteem and outcome to predict residual changes in a combined measure of nonspecific distress and anxious arousal (marginal trend) but not a combined measure of specific depressive symptoms. Unexpectedly, the greatest residual increases in distress occurred among low-self-esteem pessimists who experienced a nonfailure outcome. These effects did not appear to be mediated by changes in hopelessness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Forgiveness as a mediator of the religiosity—health relationship.

Forgiveness is proposed to be an important pathway through which the effects of religion on health are mediated. Three separate studies were conducted to examine this hypothesis. In Study 1, older adults (n = 605) completed measures of forgiveness, religiosity, and health. Feeling forgiven by God fully mediated associations between frequency of attendance, frequency of prayer, and belief in a watchful God with successful aging. Self-forgiveness and forgiveness of others partially mediated the religion–health relationships. In Study 2, 253 older adults completed measures of trait forgiveness, religiosity, and health. Trait forgiveness fully mediated associations between prayer and intrinsic religiosity with illness symptoms and 5 dimensions of successful aging. In Study 3, 80 middle-aged men and women completed state and trait forgiveness measures, as well as religiosity and health measures. State forgiveness fully mediated the relationships between existential well-being and both symptoms and medications, and trait forgiveness fully mediated the relationship between religious well-being and both intrinsic religiosity and quality of sleep. State forgiveness partially mediated the relationships between spirituality and both sleep and depression. Within adults, unselected with regard to religious affiliations or beliefs, a variety of religious variables, health outcomes, and forgiveness measures were interrelated. In the majority of cases, forgiveness either partially or fully mediated the religion–health relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)