Personal Interaction with a Reiki Practitioner Decreases Noise-Induced Microvascular Damage in an Animal Model

OBJECTIVE

To determine whether Reiki, a process of transmission of healing energy, can significantly reduce microvascular leakage caused by exposure to excessive noise using an animal model.

RATIONALE

Reiki is beginning to be used in hospitals to accelerate recovery. Despite many anecdotes describing Reiki's success, few scientific studies are reported and none of those use animals. Animal models have the advantage over human subjects in that they provide well-controlled, easily interpretable experiments. The use of noise is relevant to hospital patients because of the excessive ambient noise in hospitals in the United Kingdom and United States. Loud noise can lead to several nonauditory disorders in humans and animals that impair recovery. In the rat, stress from noise damages the mesenteric microvasculature, leading to leakage of plasma into the surrounding tissue.

DESIGN

One group of four rats simultaneously received daily noise and Reiki, while two other groups received "sham" Reiki or noise alone. A fourth group did not receive noise or additional treatment. The experiment was performed three times to test for reproducibility.

OUTCOME MEASURES

Average number and area of microvascular leaks to fluorescent albumin per unit length of venule.

RESULTS

In all three experiments, Reiki significantly reduced the outcome measures compared to the other noise groups (sham Reiki and noise alone) (p < 0.01).

CONCLUSIONS

Application of Reiki significantly reduces noise-induced microvascular leakage in an animal model. Whether or not these effects are caused by Reiki itself, or the relaxing effect of the Reiki practitioner, this procedure could be useful for minimizing effects of environmental stress on research animals and hospital patients.

Spirituality among Latinas/os: implications of culture in conceptualization and measurement

Despite growing transnational migration between the United States and Latin American countries, culturally relevant conceptualizations of spirituality among Latinas/os remain lacking in healthcare research. Grounded in Latina feminist theology, this article elucidates cultural values that influence spirituality and describes findings from a study using a new questionnaire to explore spirituality among Latinas in Puerto Rico and the US mainland. Results support the saliency of cultural values such as personalismo and familismo as the context for spiritual perspectives, which may function independently of the Catholic Church structure.

Influence of worldview on health care choices among persons with chronic pain

OBJECTIVE

The aim of this research was to examine relationships between the Pepperian worldviews of people with chronic pain and the health care choices that they make.

DESIGN

A convenience sample survey was done.

SETTING

University Medical Center Pain Clinic, Tucson, Arizona.

SUBJECTS

Men and women patients (n = 96) with nonmalignant chronic pain.

OUTCOME MEASURES

World Hypothesis Scale; Health Care Choice List.

RESULTS

Findings indicate that the combination of age and formistic worldview are statistically significant predictors of conventional health care choices by participants in this study. Older patients and persons with a predominantly formistic worldview were less likely to use complementary and alternative medicine (CAM) as a choice among this sample with chronic nonmalignant pain. Borderline significant associations were noted between persons with formistic or mechanistic worldviews and conventional health care choices, and persons with contextualistic, organismic, or equal scores in two worldview categories and CAM health care choices. Although rates of CAM use did not significantly differ from conventional choices, the prevalence rate for CAM use was high (55.2%) based on national findings.

CONCLUSIONS

Results of this study provide a link to understanding how underlying philosophies can contribute to the reasons people with chronic pain make health care decisions. Further exploration of worldviews might very well contribute to best practices for consumer health care by engaging in communication styles and belief systems consistent with consumers' personal schemas.

Positive Well-Being Changes Associated with Giving and Receiving Johrei Healing

OBJECTIVES

The aim of this study was to examine the effects of giving and receiving Johrei, a spiritual energy healing practice, on measures of well-being.

METHODS

Participants (N = 236) rated 21 items pertaining to feelings plus an overall well-being measure, before and after a Johrei session.

RESULTS

Receivers experienced a significantly greater decrease in negative emotional state than givers; however, givers and receivers experienced a comparable increase in positive emotional state and overall well-being.

CONCLUSIONS

The practice of Johrei and other energy and spiritual healing techniques, may have positive health effects for givers as well as receivers. Future research examining different energy and spiritual healing practices (for example, Reiki and Therapeutic Touch) and using various control groups (for example, treatment-naive subjects instructed to "send loving energy") can explore the generality and mechanisms underlying these apparently robust effects.

Human Biofield and Intention Detection: Individual Differences

OBJECTIVE

To evaluate a battery of biofield awareness tasks that address bioelectromagnetic and consciousness related mechanisms of action, and examine individual differences in integrative biofield awareness (IBA).

METHODS

Six (6) biofield awareness tasks were designed: 2 involved the experimenter placing his or her hands near the subject, 2 involved intense staring with associated eye movements approximately 3' from the subject, and 2 involved gentle intention with virtually no movement. Each task required a binary response from the subject. There were 10 trials per task for a total of 60 trials; blocks of 6 trials contained one of each task. Subjects were 165 undergraduate psychology students at the University of Arizona Tucson, AZ. Subjects were also assessed on their awareness of their own biofields, and they filled out various questionnaires, including estimates of how well they thought they would do and their openness to spiritual beliefs and experiences.

RESULTS

Percent IBA accuracy for the entire sample (n = 165) was 57.7 +/- 10.3% and was significantly above chance (50%) performance (t = 9.58, p < 0.0000001). Each of the 6 tasks was individually significant. Subjects significantly (t = -2.72; p < 0.007) underestimated their IBA performance below chance (mean, 46.1 +/- 18.4%). However, higher estimates predicted higher IBA (r = 0.26, n = 164, p < 0.0008). Measures of subjects' self-awareness of their own biofields, as well as belief in, and experience of, extrasensory perception (ESP) also predicted higher IBA.

CONCLUSIONS

The findings support claims of energy healers that biofield awareness can be modulated both bioelectromagnetically (locally) and via conscious intent (distally), and that individual differences in biofield awareness are related to self-awareness and sensitivity to others.

Cardiac torsion and electromagnetic fields: The cardiac bioinformation hypothesis

Although in physiology the heart is often referred to as a simple piston pump, there are in fact two additional features that are integral to cardiac physiology and function. First, the heart as it contracts in systole, also rotates and produces torsion due to the structure of the myocardium. Second, the heart produces a significant electromagnetic field with each contraction due to the coordinated depolarization of myocytes producing a current flow. Unlike the electrocardiogram, the magnetic field is not limited to volume conduction and extends outside the body. The therapeutic potential for interaction of this cardioelectromagnetic field both within and outside the body is largely unexplored. It is our hypothesis that the heart functions as a generator of bioinformation that is central to normative functioning of body. The source of this bioinformation is based on: (1) vortex blood flow in the left ventricle; (2) a cardiac electromagnetic field and both; (3) heart sounds; and (4) pulse pressure which produce frequency and amplitude information. Thus, there is a multidimensional role for the heart in physiology and biopsychosocial dynamics. Recognition of these cardiac properties may result in significant implications for new therapies for cardiovascular disease based on increasing cardiac energy efficiency (coherence) and bioinformation from the cardioelectromagnetic field. Research studies to test this hypothesis are suggested.

Strength of vital force in classical homeopathy: bio-psycho-social-spiritual correlates within a complex systems context

OBJECTIVE

To explore associations between a global rating for the classical homeopathic construct of vital force and clinician and patient ratings on previously validated bio-psycho-social-spiritual questionnaires.

METHODS

Sixty-two (62) community-recruited patients with fibromyalgia (FM) were assessed at baseline prior to a clinical trial of individualized homeopathy. Two homeopaths jointly performed case-taking interviews. A conventional medical provider independently evaluated patients with a standardized history and physical examination. Homeopaths rated each patient's vital force (five-point Likert scale, with 1 = very weak to 5 = very strong). Homeopaths and the conventional medical provider rated their Clinical Global Impression (CGI) of the severity of illness (1 = normal; 7 = among the most extremely ill). Patients completed self-rating scales on pain, global health, mood, quality of life, coping style, health locus of control, multidimensional well-being, spirituality, sense of coherence, positive states of mind, and social desirability.

RESULTS

Greater vital force ratings (mean 2.9 standard deviation [SD] 0.6) correlated moderately (p < or = 0.005) with less severe CGI illness ratings by the homeopaths (r =-0.59), decreased patient-rated mental confusion (r =-0.43), higher vigor (r = 0.38), and greater positive states of mind (r = 0.36). Vital force also showed correlations (p < 0.05) with lower CGI ratings by the conventional medical provider (r =-0.32), better selfrated quality of life (r = 0.33), lesser fatigue (r =-0.31), better global health (r = 0.29), greater sense of coherence (r = 0.28), powerful-others health locus of control (r = 0.27), increased emotional well-being (r = 0.27), and higher social desirability (r = 0.27), but not with age, pain, or illness duration.

CONCLUSION

Homeopathic vital force ratings reflect better perceived mental function, energy, and positive dimensions of the individual, beyond absence of disease.

Biofield detection: role of bioenergy awareness training and individual differences in absorption

OBJECTIVE

To measure health care providers' capacity to detect biofields before and after bioenergy awareness training in relation to individual differences in the personality trait of absorption.

METHODS

Twenty-seven (27) physicians, psychologists, and nurses participated in a 5-day intensive bioenergy healing training course with Rev. Rosalyn Bruyere. The course was part of the Associate Fellows Program in the Program in Integrative Medicine at the University of Arizona. Blindfolded participants received a 24-trial hand biofield detection test (HBDT) pretraining and post-training. The experimenter placed his or her dominant hand a few inches above the participant's left or right hand for 30-second trials. After each trial, the participant guessed which hand was being tested. Blocks contained two right- and two left-hand trials in different orders. Participants filled out Tellegen's Absorption Scale, a measure of the capacity to focus attention in tasks.

RESULTS

Percent HBDT accuracy for the entire sample was 50.8% (standard deviation [SD] = 12.24) at pretraining (50% is chance); accuracy increased to 55.5% (SD = 12.38) at post-training (t = p = 2.08, p < 0.05). Pretraining absorption (mean = 23.9; SD = 5.52) was significantly correlated with degree of detection accuracy increase (r = 0.42, n = 22, p < 0.05). High absorption (mean = 28.2 n = 11) participants increased to 58.3% compared to 52.7% for low absorption (mean = 19.2 n = 11) participants.

CONCLUSION

The findings support claims of energy healers that (1) training can improve bioenergy awareness, and (2) there are substantial individual differences in response to training.

Electroencephalographic Cordance Patterns Distinguish Exceptional Clinical Responders with Fibromyalgia to Individualized Homeopathic Medicines

OBJECTIVES

To characterize initial central nervous system responses to olfactory administration of homeopathic remedies as biomarkers for subsequently exceptional, simillimum-like clinical outcomes at a systemic level (i.e., both locally and globally).

DESIGN

Double-blinded, randomized, placebo-controlled clinical trial.

SETTING

A private homeopathic clinic in Phoenix, AZ, and a university laboratory in Tucson, AZ.

PATIENTS

Sixty-two (62) persons with physician-confirmed fibromyalgia (FM) (mean age, 49 years; 94% women) enrolled; 53 completed the 3-month assessment visit. Exceptional responders (n = 6, 23% of active treatment group; none on placebo) were those with improvements in the top one-third for both tender point pain and global health ratings after 3 months.

INTERVENTION

Patients took daily oral doses of treatment solution in LM (1/50,000 dilution) potency (active group received individualized remedy; placebo group received plain solvent). Dependent measures: Baseline and 3-month difference scores for initial prefrontal electroencephalographic alpha frequency cordance (EEG-C, a correlate of functional brain activity) during 16 pairs of randomized, double-blinded bottle sniffs (treatment minus control solutions).

RESULTS

Exceptional responders versus other patients exhibited significantly more negative initial EEG-C difference scores at prefrontal sites. Right prefrontal cordance findings correlated with subsequently reduced pain (r = 0.85, p = 0.03), better global health (r =-0.73, p = 0.10), and trait absorption (genetically determined ability to focus attention selectively and fully) (r = 0.91, p = 0.012).

CONCLUSIONS

These observations suggest prefrontal EEG-C as an early biomarker of individualized homeopathic medicine effects in patients with FM who later exhibit exceptional outcomes. Prefrontal cortex controls executive function, including ability to redirect attention. Interactions between executive function, absorption, and the simillimum remedy could facilitate exceptional responses.

Individual Differences in Response to Randomly Assigned Active Individualized Homeopathic and Placebo Treatment in Fibromyalgia: Implications of a Double-Blinded Optional Crossover Design

OBJECTIVE

To assess individual difference characteristics of subgroups of patients with fibromyalgia (FM) patients with respect to the decision to stay in or switch from randomly-assigned verum or placebo treatment during an optional crossover phase of a double-blinded homeopathy study.

DESIGN

Double-blinded, randomized, placebo-controlled, optional crossover clinical trial.

PARTICIPANTS

Fifty-three (53) community-recruited patients with FM entered the optional crossover phase.

INTERVENTION

Two homeopaths jointly selected an individualized homeopathic remedy for all patients. The pharmacy dispensed either verum LM remedy or indistinguishable placebo in accord with randomized assignment for 4 months and the patient's optional crossover decision for an additional 2 months.

OUTCOME MEASURES

Patients completed a battery of baseline state/trait questionnaires, including mood, childhood neglect and abuse, and trait absorption. They rated global health (whole person-centered) and tender point pain on physical examination (disease-specific) at baseline, 3 months, and 6 months.

RESULTS

Rates of optional crossover from verum to placebo or placebo to verum were comparable (p = 0.6; 31%, and 41%, respectively). The switch subgroups had greater baseline psychologic issues (emotional neglect in placebo-switch; depression and anger in verum-switch). The verum-stay subgroup scored highest on treatment helpfulness and included all six exceptional responders who fell, prior to crossover, into the top terciles for improvement in both global health and pain. Patients staying in their randomly assigned groups, active or placebo (n = 34), scored significantly higher in trait absorption than did those who switched groups (n = 19).

CONCLUSION

Individual difference factors may predict better and poorer responders with FM to specific and nonspecific effects of homeopathic and placebo treatment.

Measuring Effects of Music, Noise, and Healing Energy Using a Seed Germination Bioassay

OBJECTIVE

To measure biologic effects of music, noise, and healing energy without human preferences or placebo effects using seed germination as an objective biomarker.

METHODS

A series of five experiments were performed utilizing okra and zucchini seeds germinated in acoustically shielded, thermally insulated, dark, humid growth chambers. Conditions compared were an untreated control, musical sound, pink noise, and healing energy. Healing energy was administered for 15-20 minutes every 12 hours with the intention that the treated seeds would germinate faster than the untreated seeds. The objective marker was the number of seeds sprouted out of groups of 25 seeds counted at 12-hour intervals over a 72-hour growing period. Temperature and relative humidity were monitored every 15 minutes inside the seed germination containers. A total of 14 trials were run testing a total of 4600 seeds.

RESULTS

Musical sound had a highly statistically significant effect on the number of seeds sprouted compared to the untreated control over all five experiments for the main condition (p < 0.002) and over time (p < 0.000002). This effect was independent of temperature, seed type, position in room, specific petri dish, and person doing the scoring. Musical sound had a significant effect compared to noise and an untreated control as a function of time (p < 0.03) while there was no significant difference between seeds exposed to noise and an untreated control. Healing energy also had a significant effect compared to an untreated control (main condition, p < 0.0006) and over time (p < 0.0001) with a magnitude of effect comparable to that of musical sound.

CONCLUSION

This study suggests that sound vibrations (music and noise) as well as biofields (bioelectromagnetic and healing intention) both directly affect living biologic systems, and that a seed germination bioassay has the sensitivity to enable detection of effects caused by various applied energetic conditions.

Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo

OBJECTIVE

To assess the efficacy of individualized classical homeopathy in the treatment of fibromyalgia.

METHODS

This study was a double-blind, randomized, parallel-group, placebo-controlled trial of homeopathy. Community-recruited persons (N = 62) with physician-confirmed fibromyalgia (mean age 49 yr, s.d. 10 yr, 94% women) were treated in a homeopathic private practice setting. Participants were randomized to receive oral daily liquid LM (1/50,000) potencies with an individually chosen homeopathic remedy or an indistinguishable placebo. Homeopathic visits involved joint interviews and concurrence on remedy selection by two experienced homeopaths, at baseline, 2 months and 4 months (prior to a subsequent optional crossover phase of the study which is reported elsewhere). Tender point count and tender point pain on examination by a medical assessor uninvolved in providing care, self-rating scales on fibromyalgia-related quality of life, pain, mood and global health at baseline and 3 months, were the primary clinical outcome measures for this report.

RESULTS

Fifty-three people completed the treatment protocol. Participants on active treatment showed significantly greater improvements in tender point count and tender point pain, quality of life, global health and a trend toward less depression compared with those on placebo.

CONCLUSIONS

This study replicates and extends a previous 1-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy. Using a broad selection of remedies and the flexible LM dose (1/50,000 dilution factor) series, the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia.

Gas discharge visualization evaluation of ultramolecular doses of homeopathic medicines under blinded, controlled conditions

OBJECTIVES

To determine the feasibility of using a computerized biophysical method, gas discharge visualization (GDV), to differentiate ultramolecular doses of homeopathic remedies from solvent controls and from each other.

DESIGN

Blinded, randomized assessment of four split samples each of 30c potencies of three homeopathic remedies from different kingdoms, for example, Natrum muriaticum (mineral), Pulsatilla (plant), and Lachesis (animal), dissolved in a 20% alcohol-water solvent versus two different control solutions (that is, solvent with untreated lactose/sucrose pellets and unsuccussed solvent alone).

PROCEDURES

GDV measurements, involving application of a brief electrical impulse at four different voltage levels, were performed over 10 successive images on each of 10 drops from each bottle (total 400 images per test solution per voltage). The dependent variables were the quantified image characteristics of the liquid drops (form coefficient, area, and brightness) from the resultant burst of electron-ion emission and optical radiation in the visual and ultraviolet ranges.

RESULTS

The procedure generated measurable images at the two highest voltage levels. At 17 kV, the remedies exhibited overall lower image parameter values compared with solvents (significant for Pulsatilla and Lachesis), as well as differences from solvents in fluctuations over repeated images (exposures to the same voltage). At 24 kV, other patterns emerged, with individual remedies showing higher or lower image parameters compared with other remedies and the solvent controls.

CONCLUSIONS

GDV technology may provide an electromagnetic probe into the properties of homeopathic remedies as distinguished from solvent controls. However, the present findings also highlight the need for additional research to evaluate factors that may affect reproducibility of results.

The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: an exploratory study

OBJECTIVE

The diagnosis of breast cancer, the most common type of cancer among American women, elicits greater distress than any other diagnosis regardless of prognosis. Therefore, the present study examined the efficacy of a stress reduction intervention for women with breast cancer.

METHODS

As part of a larger, randomized, controlled study of the effects on measures of stress of a mindfulness-based stress reduction (MBSR) intervention for women with breast cancer, the current analyses examined the effects on sleep complaints.

RESULTS

Analyses of the data indicated that both MBSR and a free choice (FC) control condition produced significant improvement on daily diary sleep quality measures though neither showed significant improvement on sleep-efficiency. Participants in the MBSR who reported greater mindfulness practice improved significantly more on the sleep quality measure most strongly associated with distress.

CONCLUSION

MBSR appears to be a promising intervention to improve the quality of sleep in woman with breast cancer whose sleep complaints are due to stress.

Going quasi: the premature disclosure effect in a randomized clinical trial

This paper describes a randomized clinical trial investigating a stress management program for women with breast cancer, which inadvertently turned quasi-experimental. Due to logistical considerations, group assignment was disclosed to participants (n = 63) prior to baseline assessment. Analyses of baseline measures unexpectedly revealed statistically significant differences between groups on psychological functioning. We suggest that what appears to be failed randomization may in fact point toward an important phenomenon which we have termed premature disclosure effect (PDE). A hierarchical regression model, developed to help explain the PDE, accounted for 47% of the variance. The findings indicate the importance of considering participant belief, preferences, and attributes when designing research protocols and interventions. Potential implications of PDE for clinical research in behavioral medicine are discussed and specific statistical methodologies suggested.

Translating a nonlinear systems theory model for homeopathy into empirical tests

Various investigators have proposed that nonlinear systems theory, notably chaos and complexity theory, provides a heuristically useful modelfor conceptualizing the way in which complementary and alternative medicine therapies, which purport to modify subtle energies, effect change throughout the individual as a whole. In this paper we apply this theory to classical homeopathy and outline an empirical approach for testing the resultant hypotheses. Such research may advance understanding of the mechanisms of homeopathic remedy effects and provide a direction for homeopathic research that expands the previous emphasis on clinical trials and the remedies themselves. In refocusing attention on the dynamics of the patient as a nonlinear complex system, the proposed research program is consistent with the homeopathic emphasis on the individual rather than the disease. This approach may have additional applications that can elucidate similar effects of other energy medicine modalities (eg, acupuncture) on the healing process of the person as a unified whole.

Homeopathic constitutional type questionnaire correlates of conventional psychological and physical health scales: individual difference characteristics of young adults

This study examined associations between scores for 19 different remedies on the constitutional type questionnaire (CTQ) and scores on standardized psychological and medical trait and state scales from health psychology research. Subjects were 104 young adult American college students (mean age 20 years; 67% female). Scales included the chemical intolerance index (CII) for environmental sensitivity, the NEO personality inventory, Marlowe-Crowne social desirability (MCSD) Scale for defensiveness, Harvard parental caring scale (HPCS) for perceived mother and father traits, Profile of Mood State (POMS) scale, Pennebaker symptom checklist (PSC), and a 3-item global health rating scale. The majority of CTQ constitutional type scores correlated significantly with greater NEO neuroticism, lower MCSD defensiveness, and greater psychological distress on the POMS subscales. NEO Extraversion and Openness subscales correlated with specific CTQ scores in directions consistent with clinical remedy pictures. CTQ Carcinosin differed from other remedies, showing no significant correlations with other scales. As hypothesized (a) persons high on CTQ scores for Carcinosin and low in parental caring (HPCS) had the highest symptom score; (b) those high on CTQ scores for Sulphur and low on HPCS had the poorest global health ratings; (c) individuals high on four different CTQ type scores (Carcinosin, Lachesis, Nux vomica, Sulphur) and high on environmental sensitivity (CII) exhibited the highest symptom scores. Taken together, the data offer additional validation of the CTQ and provide a foundation for studying interactions of constitutional type with both psychosocial and physicochemical environmental factors in homeopathic provers and patients.

Defensiveness and individual response stereotypy in asthma

OBJECTIVE

Previous literature has shown that the psychological trait of defensiveness is related to elevated sympathetic reactivity to stress and to several cardiac risk factors. The aim of this study was to examine whether these previous findings on defensiveness extend to an asthmatic population.

METHODS

Defensiveness was measured by the Marlowe-Crowne Social Desirability Scale using a quartile split: high (upper 25%) and low (bottom 75%). Twenty-two defensive and 66 nondefensive participants with asthma were exposed to laboratory tasks (initial baseline rest period, reaction time task, and a shop accident film).

RESULTS

During the tasks there was evidence of lower skin conductance levels and greater respiratory sinus arrhythmia amplitudes among defensive patients with asthma. After exposure to the tasks, defensive patients with asthma showed a decline on spirometry test measures compared with nondefensive asthmatic patients, who displayed an increase.

CONCLUSIONS

These data confirm individual response stereotypy and suggest that defensiveness may be characterized by sympathetic hypoarousal and parasympathetic hyperarousal among patients with asthma. Future studies are needed to determine whether defensiveness is a risk factor for stress-induced bronchoconstriction.

EEG beta 1 oscillation and sucrose sensitization in fibromyalgia with chemical intolerance

Patients with fibromyalgia (FM) have diffuse musculoskeletal pain; half report concomitant intolerance for low levels of environmental chemicals (CI). Previous investigators have hypothesized that the chronic pain and chemical intolerance reflect sensitization of different central nervous system limbic and/or mesolimbic reward pathways. We evaluated electroencephalographic (EEG) beta activity and blood glucose responses of FM patients with and without CI and normals during three repeated sucrose ingestion sessions and during a final, water-only session (testing for conditioning). The FM with CI exhibited oscillation (reversal in direction of change from session to session) at rest and then sensitization (progressive amplification) of EEG beta 1 over time across the 3 sucrose sessions versus controls. FM with CI showed sensitization of blood glucose over the 3 sucrose sessions, which, like the EEG findings, reverted toward baseline in the final water-only session. The data suggest that the subset of FM patients with CI have increased susceptibility to oscillation and physiological sensitization without conditioning, perhaps contributing to fluctuations in their chronic course.

Quality of life and breast cancer: relationship to psychosocial variables

The aim of this article is to shed more light on the relationship between quality of life and aspects of the psychosocial experience for women with breast cancer. The literature is briefly reviewed, including highlights of the psychosocial consequences of cancer, an exploration of the relationship of psychosocial variables to cancer, and a brief review of psychosocial interventions for cancer. Further, preliminary findings of an on-going NCI study are introduced. Finally, clinical implications are discussed. The purpose of this article is to provide a context and foundation on which future researchers and clinicians can build. Ultimately, we suggest that the biomedical model of disease, though crucial, does not take into account all of the complex factors involved in cancer. The current literature lends support to the argument that a broader, more integrative framework, which includes psychosocial factors, is needed.