The role of social cognitive processing theory and optimism in positive psychosocial and physical behavior change after cancer diagnosis and treatment

The physical and psychosocial 'health' behaviors of cancer patients have become a more pressing issue as 5-year survival rates continue to rise. This study investigated: (a) the extent of positive change in four psychosocial behaviors and two physical health behaviors, (b) the role of psychosocial predictors (drawn from theories of Social Cognitive Processing and optimism) in positive behavior change after cancer diagnosis and treatment, and (c) the possible influence of social desirability in reports of positive psychosocial and physical behavior change. The behavior showing the greatest positive change was time spent reflecting on life priorities; the behavior that was least likely to change after diagnosis and treatment was exercise. Optimism, social support, and cancer-related intrusions were positively associated with increases in physical health behaviors. Only optimism was positively associated with increases in psychosocial behaviors. Reports of positive change in physical and psychosocial behaviors were only modestly correlated. Social desirability was unrelated to reports of positive behavior change. Results are interpreted in light of theories of adaptation to cancer diagnosis and treatment.

Information seeking during "bad news" oncology interactions: Question asking by patients and their companions

Previous research has investigated patient question asking in clinical settings as a strategy of information seeking and as an indicator of the level of active patient participation in the interaction. This study investigates questions asked by patients and their companions during stressful encounters in the oncology setting in the USA. We transcribed all questions patients and companions asked the oncologist during 28 outpatient interactions in which "bad news" was discussed (n = 705) and analyzed them for frequency and topic. Additionally, we analyzed the extent to which personal and demographic characteristics and independently obtained ratings of the oncologist-patient/companion relationships were related to question asking. Findings demonstrated that at least one companion was present in 24 (86%) of the 28 interactions and companions asked significantly more questions than patients. The most frequently occurring topics for both patients and companions were treatment, diagnostic testing, diagnosis, and prognosis. In general, personal and demographic characteristics were unrelated to question asking, but older patients asked fewer questions, while more educated patients asked more questions. With regard to ratings of the quality of the dyadic relationships, results showed that "trust" between the physician and companions was positively correlated and "conversational dominance by physician" was negatively correlated with the frequency of companion questions. Additionally, positive ratings of the relationship between physicians and companions were correlated with fewer patient questions. This study demonstrates that companions are active participants in stressful oncology interactions. Future research and physician training in communication would benefit from expanding the focus beyond the patient-physician dyad to the roles and influence of multiple participants in medical interactions.

Parent communication and child pain and distress during painful pediatric cancer treatments

Children with cancer often consider treatment procedures to be more traumatic and painful than cancer itself. Previous research indicates that parents' behavior before and during painful medical procedures influences children's distress level. Understanding parents' naturally occurring communication patterns is essential to identifying families in need of an intervention to enhance coping and emotional well-being. Using the concept of definition of the situation from a symbolic interactionism theoretical framework, this study developed a typology of parent communication patterns and tested relationships between those patterns and children's responses to potentially painful treatment procedures. Analyses are based on video-recorded observations of 31 children and their primary parents (individuals functioning in a parenting role and serving as the primary familial caregivers during the observed procedure) in the USA during clinic visits for potentially painful pediatric oncology treatments. Four communication patterns emerged: normalizing, invalidating, supportive, and distancing. The most common communication patterns differed by clinic visit phase: normalizing during pre-procedure, supportive during procedure, and both distancing and supportive during post-procedure. Parents' communication also varied by procedure type. Supportive communication was most common during lumbar punctures; normalizing and distancing communication were most common during port starts. Six children (19.4%) experienced invalidation during at least one clinic visit phase. Analyses indicated that invalidated children experienced significantly more pain and distress than children whose parents used other communication patterns. This typology provides a theoretical approach to understanding previous research and offers a framework for the continuing investigation of the influence of parents' communication during potentially painful pediatric oncology procedures.

The role of shame, anger, and affect regulation in men's perpetration of psychological abuse in dating relationships

This study determines the relationships between shame, anger, and men's perpetration of psychological abuse in dating relationships. The authors hypothesize the connection between shame proneness and men's use of psychological abuse with a dating partner, with anger's mediating in this relationship. In addition, the authors hypothesize that affect regulation would moderate the relationship between anger and men's use of psychological abuse. Results indicate that shame proneness and use of psychological abuse are significantly related and that anger mediates the relationship. However, affect regulation does not moderate the effects of anger on men's use of psychological abuse. These findings are consistent with theoretical conceptualizations of shame and have implications for intervention and treatment programs for perpetrators of psychological abuse in dating relationships.

Application of the theory of planned behavior to understand intentions to engage in physical and psychosocial health behaviors after cancer diagnosis

A cancer diagnosis can trigger change in both lifestyle behaviors and mental health outcomes such as 'growth' and 'benefit-finding'. Assuming changes in mental health outcomes are based upon changes in specific behaviors, the Theory of Planned Behavior (TPB) may facilitate understanding of post-diagnosis change in physical and psychosocial 'health' behaviors. Adults (n = 130) < or =2 years post-cancer diagnosis completed an internet survey. Current performance and future behavior intentions for two physical (e.g. eating a healthy diet) and four psychosocial (e.g. spending quality time with family/friends; engaging in spiritual or religious activities) health behaviors were assessed. TPB constructs (subjective norm, behavior attitudes, perceived behavioral control) for each of the six behaviors were also assessed. Multiple regression analyses indicated the set of TPB constructs accounted for an increment of 25-53% of variance in behavioral intentions beyond that accounted for by clinical and demographic variables. Among individual TPB constructs, behavioral attitude was most consistently associated with behavioral intentions while subjective norm was least consistently associated with behavioral intentions. The TPB could serve as a comprehensive model for understanding change in both physical and psychosocial health behaviors after cancer diagnosis and could suggest innovative approaches to developing interventions to enhance post-diagnosis 'growth' and 'benefit finding'.

The impact of partner psychological abuse on health behaviors and health status in college women

Previous research documents increased health problems, somatic complaints, and negative health behaviors among victims of physical and sexual violence. This study extended existing literature by examining the unique effects of partner psychological abuse on physical health and the moderating effects of approach and avoidance coping strategies. Psychological abuse was positively related to illegal drug use, physical and role limitations, negative health perceptions, and cognitive impairment in college women even after controlling for physical victimization. Psychological abuse was not related to sleep hygiene, exercise, problem drinking, or smoking. Approach coping moderated the effects of partner psychological abuse on binge drinking and health perceptions. Low approach coping was associated with more binge drinking and negative health perceptions as abuse increased; high approach coping did not show a significant relationship with binge drinking or health perceptions across levels of abuse. Avoidance coping showed only a trend as a moderator of illegal drugs.

The moderating role of parental warmth on the effects of exposure to family violence

Previous research has shown parental warmth to have mixed effects on individuals in violent families. While positively associated with psychological health in some victims, parental warmth has also been positively associated with measures of psychological distress in other victims. The current study examined two models (the "buffering" and "inconsistency" theories) to clarify the effects of parental warmth. The current study also sought to clarify the role of parental warmth within the context of exposure to different types of family violence (i.e., witnessing versus victimization). Results differed depending on the type of violence exposure. Both mother and father warmth were negatively associated with secure attachment and self-esteem in combined victims and witnesses of violence, whereas, mother warmth was positively associated with self-esteem in witnesses of violence. Father warmth did not significantly impact either outcome for witnesses. Parental warmth did not influence either outcome for those who had only experienced victimization.