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Association between the Big Five personality traits and medication adherence in patients with cardiovascular disease: A cross-sectional study. PLoS One 2022; 17:e0278534. [PMID: 36454925 PMCID: PMC9714849 DOI: 10.1371/journal.pone.0278534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
The correlation between personality traits and health outcomes of primary prevention has been examined. However, there is a lack of evidence on the association between the assessment of personality traits and medication adherence for secondary prevention of cardiovascular disease. Thus, this study aimed to explore the association between personality traits and medication adherence, including compliance to prescribed medications and attitudes toward taking medications among patients with cardiovascular disease. This cross-sectional study included patients hospitalized for cardiovascular disease. We assessed the Big Five personality traits (conscientiousness, neuroticism, openness, extraversion, and agreeableness) of each patient at discharge using the Ten-Item Personality Inventory. In addition, we evaluated four aspects of medication adherence using a 12-item version of the medication adherence scale: medication compliance, collaboration with health care providers, willingness to access and use information on medication, and acceptance to take medication. Logistic regression analysis was performed to assess the correlation between the level of each medication adherence domain and each personality trait. The data of 128 patients with cardiovascular disease were analyzed. Higher conscientiousness score was significantly associated with a high compliance score (odds ratio per 1 point increase, 1.90; 95% confidence interval, 1.30-2.79; p = 0.001), high collaboration score (1.90; 1.31-2.76; p = 0.001), and high willingness score (1.74; 1.19-2.54; p = 0.004) after adjustment for potential confounders. Other combinations of personality traits and medication adherence showed no statistically significant correlations in multivariate analyses. The findings of this study suggest that assessment of personality traits, especially conscientiousness, may facilitate patient-medical staff communication for the improvement of medication adherence in patients with cardiovascular disease.
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Poor respiratory health outcomes associated with high illness worry and alexithymia: Eleven-year prospective cohort study among the working-age population. J Psychosom Res 2022; 155:110751. [PMID: 35152185 DOI: 10.1016/j.jpsychores.2022.110751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/13/2022] [Accepted: 01/31/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Poor respiratory health outcomes have been associated with poorer physical health and higher psychological distress. The aim of this study was to investigate whether illness worry, alexithymia or low sense of coherence predict i) the onset of new respiratory disease, ii) respiratory symptoms or iii) lung function among the working-age population, independently of comorbidity mood-, anxiety, or alcohol abuse disorders. METHODS The study was conducted among a nationally representative sample of the Finnish population (BRIF8901) aged 30-54 years (N = 2310) in 2000-2001 and was followed up in 2011. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder at baseline were excluded. Lung function was measured by a spirometry test and psychiatric disorders were diagnosed using a structured clinical interview. Structured questionnaires were used to measure self-reported respiratory symptoms and diseases, illness worry, alexithymia, and sense of coherence. RESULTS High illness worry predicted an 11-year incidence of asthma (OR 1.47, 95% CI 1.09-1.99, p = 0.01). Alexithymia predicted shortness of breath (OR 1.32, 95% CI 1.13-1.53, p < 0.01) and 11-year incidence of COPD (OR 2.84, 95% CI 1.37-5.88, p < 0.01), even after several adjustments for physical and mental health. Psychological dispositions did not associate with lung function in 2011. CONCLUSIONS In the general population, psychological factors that modify health behaviour predicted adverse respiratory health outcomes independently of lung function after 11 years of follow-up. This indicates that considering them part of personalized treatment planning is important for promoting health-related behaviour among the working-age population.
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Kannampallil T, Holzer KJ, Abraham J, Naim U, Lenze EJ, Haroutounian S, Avidan MS. Surgical Complications in Older Adults Predict Decline in Self-Perceived Cognitive Function in the Ensuing Year: A Cohort Study. Am J Geriatr Psychiatry 2021; 29:352-361. [PMID: 32981851 DOI: 10.1016/j.jagp.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Surgical complications are common among older adults and are potential indicators of poorer long-term outcomes. The authors examined the effects of in-hospital complications on changes in older adults' self-perceived cognitive function in the year after surgery. METHOD The authors conducted a prospective longitudinal study with 2,155 older adults (age ≥ 65) undergoing surgery, investigating the association between self-reported, in-hospital complications after surgery and Patient-Reported Outcomes Measurement Information System Applied Cognition-Abilities survey (4 items, cognitive function) at 30 days and 1 year after surgery. Surveys were scored on a continuous scale of 0-100, with higher scores representing better self-perceived cognitive functioning. Patient characteristics including demographics, type of complications, surgery type, pain, and activities of daily living were also collected. RESULTS Having one in-hospital complication was associated with a decrease of 1.79 points (95% confidence interval (CI): -2.78, -0.80), indicating lower self-perceived cognitive functioning at 1 year after surgery; having two or more in-hospital complications was associated with 2.82 point (95% CI: -4.50, -1.15) decrease at 1 year after surgery. Models specific to complication type indicated that respiratory [-3.04, (95% CI: -5.50, -0.57)], neural [-2.11, (95% CI: -3.97, -0.25)], and general complications [-2.39, (95% CI: -3.51, -1.28)] were associated with statistically significant decreases in cognitive function. DISCUSSION Older surgical patients who suffer in-hospital complications show greater decline in self-perceived cognitive function during the ensuing year. Geriatric specialists may be able to intervene in the immediate perioperative period to reduce complications and possibly mitigate cognitive decline among older adults.
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Affiliation(s)
- Thomas Kannampallil
- Department of Anesthesiology (TK, KJH, JA, UN, SH, MSA), Washington University School of Medicine, St Louis, MO; Institute for Informatics (TK, JA), Washington University School of Medicine, St Louis, MO.
| | - Katherine J Holzer
- Department of Anesthesiology (TK, KJH, JA, UN, SH, MSA), Washington University School of Medicine, St Louis, MO
| | - Joanna Abraham
- Department of Anesthesiology (TK, KJH, JA, UN, SH, MSA), Washington University School of Medicine, St Louis, MO; Institute for Informatics (TK, JA), Washington University School of Medicine, St Louis, MO
| | - Uzma Naim
- Department of Anesthesiology (TK, KJH, JA, UN, SH, MSA), Washington University School of Medicine, St Louis, MO
| | - Eric J Lenze
- Department of Psychiatry (EJL), Washington University School of Medicine, St Louis, MO
| | - Simon Haroutounian
- Department of Anesthesiology (TK, KJH, JA, UN, SH, MSA), Washington University School of Medicine, St Louis, MO
| | - Michael S Avidan
- Department of Anesthesiology (TK, KJH, JA, UN, SH, MSA), Washington University School of Medicine, St Louis, MO
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Enge S, Fleischhauer M, Hadj-Abo A, Butt F, Kirschbaum C, Schmidt K, Miller R. Comparison of hair cortisol concentrations between self- and professionally-collected hair samples and the role of five-factor personality traits as potential moderators. Psychoneuroendocrinology 2020; 122:104859. [PMID: 32992135 PMCID: PMC7462524 DOI: 10.1016/j.psyneuen.2020.104859] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/17/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022]
Abstract
Cortisol concentration of hair (HCC) is an established biomarker in stress research that can provide valuable retrospective information on subjects' long-term cortisol levels. Using a population-wide sample of in total N = 482 participants this study aimed to examine whether there are differences in HCC when participants collect the required samples by themselves with the help of a partner in domestic settings compared to professionally collected hair strands in the lab. Potential confounding factors that may affect HCC and might obfuscate the outcomes were considered. The results suggest that the two compared sample collection methods did not significantly differ from each other in terms of HCC (p = .307). A somewhat larger sample loss in the domestic setting was observed due to hair samples where HCC could not be determined (5.3 % vs. 1.8 % in the lab). Similarly, in a sample of N = 50 using a within-subjects design (Sample 2) no significant HCC differences between collection methods occurred (p = .206). In addition, potential moderating effects of personality traits of the Five-Factor-Model on the relationship between hair collection method and HCC were investigated. In Sample 1 personality data of the hair donor were available, while in Sample 2 personality data (n = 40) were available for the hair donor and the hair sample collector. Interestingly, none of the Big Five traits significantly moderated the relationship between HCC and hair collection method (all p > .20). Overall, these findings suggest that the self-collection of hair in domestic settings is a viable and economical method for measuring long-term cortisol concentrations in hair.
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Affiliation(s)
- Sören Enge
- Faculty of Natural Sciences, Department of Psychology, Medical School Berlin, Germany; Faculty of Psychology, Technische Universität Dresden, Germany.
| | - Monika Fleischhauer
- Faculty of Natural Sciences, Department of Psychology, Medical School Berlin, Germany
| | - Alexander Hadj-Abo
- Faculty of Natural Sciences, Department of Psychology, Medical School Berlin, Germany
| | - Felix Butt
- Faculty of Natural Sciences, Department of Psychology, Medical School Berlin, Germany
| | | | | | - Robert Miller
- Faculty of Psychology, Technische Universität Dresden, Germany
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Asman AG, Hoogendoorn CJ, McKee MD, Gonzalez JS. Assessing the association of depression and anxiety with symptom reporting among individuals with type 2 diabetes. J Behav Med 2019; 43:57-68. [PMID: 31111355 DOI: 10.1007/s10865-019-00056-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/09/2019] [Indexed: 12/27/2022]
Abstract
Depression and anxiety have been linked to increased somatic symptoms among individuals with type 2 diabetes (T2D), but their independent effects and role in symptom attributions remain unclear. This study examined depression and anxiety in relation to total symptoms and symptom attributions in a diverse sample of 120 adults with T2D. Multiple linear regression tested associations after controlling for medical comorbidities and insulin use. Clinician-rated depression (β = .53, p < .001), self-reported depression (β = .59, p < .001) and self-reported anxiety (β = .62, p < .001) were positively associated with total somatic symptoms. Models adjusting for depression and anxiety revealed significant independent effects for each, regardless of measurement method. In attribution models, only self-reported depression (β = .27, p = .003) was significantly associated with greater attribution to diabetes, whereas clinician-rated depression (β = .19, p = .047), self-reported depression (β = .38, p < .001) and anxiety (β = .28, p = .004) were associated with increased attribution to medications. In models adjusting for depression and anxiety, self-reported depression was a significant independent predictor of diabetes (β = .29, p = .023) and medication (β = .38, p = .004) attribution; anxiety was a significant predictor of medication attribution (β = .25, p = .039). Findings suggest depression and anxiety are implicated in overall increases in somatic symptom complaints and an increased tendency to attribute these symptoms to diabetes and side-effects of diabetes medications among adults with T2D.
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Affiliation(s)
- Arielle G Asman
- Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
| | - Claire J Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
| | - M Diane McKee
- Albert Einstein College of Medicine, Bronx, NY, USA.,Montefiore Health System, Bronx, NY, USA.,New York Regional Center for Diabetes Translation Research, Bronx, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA. .,Albert Einstein College of Medicine, Bronx, NY, USA. .,Montefiore Health System, Bronx, NY, USA. .,New York Regional Center for Diabetes Translation Research, Bronx, NY, USA. .,The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, NY, USA.
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Pollard S, Bansback N, FitzGerld JM, Bryan S. The burden of nonadherence among adults with asthma: a role for shared decision-making. Allergy 2017; 72:705-712. [PMID: 27873330 DOI: 10.1111/all.13090] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2016] [Indexed: 01/29/2023]
Abstract
A shared approach to decision-making framework has been suggested for chronic disease management especially where multiple treatment options exist. Shared decision-making (SDM) requires that both physician and patients are actively engaged in the decision-making process, including information exchange; expressing treatment preferences; as well as agreement over the final treatment decision. Although SDM appears well supported by patients, practitioners and policymakers alike, the current challenge is to determine how best to make SDM a reality in everyday clinical practice. Within the context of asthma, adherence rates are poor and are linked to outcomes such as reduced asthma control, increased symptoms, healthcare expenditures, and lower patient quality of life. It has been suggested that SDM can improve treatment adherence and that ignoring patients' personal goals and preferences may result in reduced rates of adherence. Furthermore, understanding predictors of poor treatment adherence is a necessary step toward developing effective strategies to improve the patient-reported and clinically important outcomes. Here, we describe why a shared approach to treatment decision-making for asthma has the potential to be an effective tool for improving adherence, with associated clinical and patient-related outcomes. In addition, we explore insights into the reasons why SDM has not been implemented into routine clinical practice.
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Affiliation(s)
- S. Pollard
- School of Population and Public Health; University of British Columbia; Vancouver BC Canada
- Centre for Clinical Epidemiology and Evaluation; Vancouver Coastal Research Institute; Vancouver BC Canada
| | - N. Bansback
- School of Population and Public Health; University of British Columbia; Vancouver BC Canada
- Centre for Clinical Epidemiology and Evaluation; Vancouver Coastal Research Institute; Vancouver BC Canada
- Centre for Health Evaluation and Outcome Sciences; St Paul's Hospital; Vancouver BC Canada
| | - J. M. FitzGerld
- Centre for Clinical Epidemiology and Evaluation; Vancouver Coastal Research Institute; Vancouver BC Canada
- Institute for Heart and Lung Health; Faculty of Medicine; University of British Columbia; Vancouver BC Canada
| | - S. Bryan
- School of Population and Public Health; University of British Columbia; Vancouver BC Canada
- Centre for Clinical Epidemiology and Evaluation; Vancouver Coastal Research Institute; Vancouver BC Canada
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Câmara-Costa H, Bull KS, Kennedy C, Wiener A, Calaminus G, Resch A, Kieffer V, Lalande C, Poggi G, von Hoff K, Grill J, Doz F, Rutkowski S, Massimino M, Kortmann RD, Lannering B, Dellatolas G, Chevignard M. Quality of survival and cognitive performance in children treated for medulloblastoma in the PNET 4 randomized controlled trial. Neurooncol Pract 2017; 4:161-170. [PMID: 31385949 DOI: 10.1093/nop/npw028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The relationship between direct assessments of cognitive performance and questionnaires assessing quality of survival (QoS) is reported to be weak-to-nonexistent. Conversely, the associations between questionnaires evaluating distinct domains of QoS tend to be strong. This pattern remains understudied. Methods In the HIT-SIOP PNET4 randomized controlled trial, cognitive assessments, including Full Scale, Verbal and Performance IQ, Working Memory, and Processing Speed, were undertaken in 137 survivors of standard-risk medulloblastoma from 4 European countries. QoS questionnaires, including self-reports and/or parent reports of the Behavior Rating Inventory of Executive Function (BRIEF), the Health Utilities Index, the Strengths and Difficulties Questionnaire, and the Pediatric Quality of Life Inventory, were completed for 151 survivors. Correlations among direct cognitive assessments, QoS questionnaires, and clinical data were examined in participants with both assessments available (n = 86). Results Correlations between direct measures of cognitive performance and QoS questionnaires were weak, except for moderate correlations between the BRIEF Metacognition Index (parent report) and working memory (r = .32) and between health status (self-report) and cognitive outcomes (r = .35-.44). Correlations among QoS questionnaires were moderate to strong both for parent and self-report (r = .39-.76). Principal Component Analysis demonstrated that questionnaires and cognitive assessments loaded on 2 separate factors. Conclusions We hypothesize that the strong correlations among QoS questionnaires is partially attributable to the positive/negative polarity of all questions on the questionnaires, coupled with the relative absence of disease-specific questions. These factors may be influenced by respondents' personality and emotional characteristics, unlike direct assessments of cognitive functioning, and should be taken into account in clinical trials.
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Affiliation(s)
- Hugo Câmara-Costa
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France (H.C.C., G.D.)
| | - Kim S Bull
- University of Southampton, Faculty of Medicine, Southampton, SO16 6YD, UK (K.S.B., C.K.)
| | - Colin Kennedy
- University of Southampton, Faculty of Medicine, Southampton, SO16 6YD, UK (K.S.B., C.K.)
| | - Andreas Wiener
- University of Bonn, Paediatric Oncology, Bonn and University Hospital Muenster, Paediatric Oncology, Münster, Germany (A.W., G.C.)
| | - Gabriele Calaminus
- University of Bonn, Paediatric Oncology, Bonn and University Hospital Muenster, Paediatric Oncology, Münster, Germany (A.W., G.C.)
| | - Anika Resch
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.R., K.V.H., S.R.)
| | - Virginie Kieffer
- Hôpitaux de Saint Maurice, Saint Maurice; Groupe de Recherche Clinique Handicap Cognitif et Réadaptation; UPMC Paris 6, France (V.K.)
| | | | - Geraldina Poggi
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy (G.P.)
| | - Katja von Hoff
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.R., K.V.H., S.R.)
| | - Jacques Grill
- Gustave Roussy, Villejuif 94805, France (C.L., J.G.).,Université Paris Saclay, Villejuif 94805, France (J.G.)
| | - François Doz
- Institut Curie and University Paris Descartes, Sorbonne Paris Cité, Paris, France (F.D.)
| | - Stefan Rutkowski
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.R., K.V.H., S.R.)
| | - Maura Massimino
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy (M.M.)
| | - Rolf-Dieter Kortmann
- University of Leipzig, Department of Radiation Therapy, Leipzig, Germany (R.D.K.)
| | - Birgitta Lannering
- University of Gothenburg, Department of Paediatric Oncology, Gothenburg, Sweden (B.L.)
| | - Georges Dellatolas
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France (H.C.C., G.D.)
| | - Mathilde Chevignard
- Saint Maurice Hospitals, Rehabilitation Department for children with acquired neurological injury; F-94410 Saint Maurice, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, CNRS, LIB, F-7013 Paris, France (M.C.)
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Howland M, Tatsuoka C, Smyth KA, Sajatovic M. Evaluating PROMIS(®) applied cognition items in a sample of older adults at risk for cognitive decline. Psychiatry Res 2017; 247:39-42. [PMID: 27863317 PMCID: PMC5990004 DOI: 10.1016/j.psychres.2016.10.072] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 10/05/2016] [Accepted: 10/30/2016] [Indexed: 11/20/2022]
Abstract
PROMIS(®) Applied Cognition is a short self-assessment of cognitive abilities and concerns that eliminates the need for a trained rater and provides online question banks that can be uniformly used across health care providers. This 12-month prospective study of 281 elderly individuals evaluates self-perceptions of cognitive functioning in relation to objective cognition, or assessment by an external rater, and compares PROMIS® Applied Cognition Abilities and Concerns subsets with commonly used "legacy" instruments. PROMIS® correlated with objective legacy measures (the Mini-Mental State Examination [MMSE] and Saint Louis University Mental Status [SLUMS] examination), depression (measured with the Geriatric Depression Scale [GDS]), anxiety, and activities of daily living. PROMIS® and MMSE correlations remained after controlling for depression and anxiety. PROMIS® associated more strongly than MMSE with depression, highlighting the relationship between subjective cognitive deficit and depression. One-year changes in PROMIS® correlated with one-year changes in MMSE and GDS. The PROMIS® Abilities subset more strongly correlated with objective cognition, whereas the Concerns subset more strongly correlated with depression and activities of daily living. PROMIS® seems to be a reasonable prescreening tool to identify patients with cognitive decline or psychological distress.
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Affiliation(s)
- Molly Howland
- Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH 44106, USA.
| | - Curtis Tatsuoka
- Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH 44106, USA; Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH 44106, USA; Department of Neurology, Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH 44106, USA.
| | - Kathleen A Smyth
- Department of Neurology, Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH 44106, USA.
| | - Martha Sajatovic
- Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH 44106, USA; Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH 44106, USA; Department of Neurology, Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH 44106, USA; Department of Psychiatry, Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH 44106, USA.
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Corbett T, Groarke A, Walsh JC, McGuire BE. Cancer-related fatigue in post-treatment cancer survivors: application of the common sense model of illness representations. BMC Cancer 2016; 16:919. [PMID: 27884127 PMCID: PMC5123423 DOI: 10.1186/s12885-016-2907-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 10/28/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cancer-related fatigue (CrF) is a common and disruptive symptom that may be experienced during and after cancer. Research into the subjective experience of fatigue in this group is required. The common sense model of self-regulation of health and illness (SRM) addresses personal beliefs or mental representations-whether medically sound or unsubstantiated- that a person holds about a health issue. The current study assesses if the SRM could be used as a theoretical framework for organizing the experiences of people with CrF, with a view to identifying methods to address fatigue in cancer survivors. METHOD Four focus groups were held with a total of 18 cancer survivors who reported they experienced 'significant fatigue or reduced energy.' A thematic analysis was conducted within the framework of the SRM. RESULTS Findings were aligned with the SRM, with participants discussing fatigue with reference to representation, coping, and appraisal of symptoms. In particular, the wider social context of CrF was frequently addressed. Perceived inadequacies in support available to those with lingering fatigue after the completion of cancer treatment were highlighted by the participants. CONCLUSION This study explored the subjective experience of fatigue after cancer using the SRM. CrF should be approached as a complex psychosocial issue and considered from the patient perspective to facilitate better understanding and management of symptoms. The SRM is an applicable framework for identifying modifiable factors that could lead to improved coping with CrF in post-treatment cancer survivors.
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Affiliation(s)
- Teresa Corbett
- School of Psychology, National University of Ireland Galway, Galway, Ireland.
| | - AnnMarie Groarke
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jane C Walsh
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Brian E McGuire
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Wilski M, Tomczak M. Comparison of Personal Resources in Patients Who Differently Estimate the Impact of Multiple Sclerosis. Ann Behav Med 2016; 51:179-188. [DOI: 10.1007/s12160-016-9841-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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11
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Whitehead BR, Bergeman CS. Affective health bias in older adults: Considering positive and negative affect in a general health context. Soc Sci Med 2016; 165:28-35. [PMID: 27485730 DOI: 10.1016/j.socscimed.2016.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 07/06/2016] [Accepted: 07/20/2016] [Indexed: 01/22/2023]
Abstract
RATIONALE Because subjective health reports are a primary source of health information in a number of medical and research-based contexts, much research has been devoted to establishing the extent to which these self-reports of health correspond to health information from more objective sources. One of the key factors considered in this area is trait affect, with most studies emphasizing the impact of negative affect (negative emotions) over positive affect (positive emotions), and focusing on high-arousal affect (e.g., anger, excitement) over moderate- or low-arousal affect (e.g., relaxed, depressed). OBJECTIVES The present study examines the impact of both Positive and Negative Affect (PA/NA)-measured by items of both high and low arousal-on the correspondence between objective health information and subjective health reports. Another limitation of existing literature in the area is the focus on samples suffering from a particular diagnosis or on specific symptom reports; here, these effects are investigated in a sample of community-dwelling older adults representing a broader spectrum of health. METHOD 153 older adults (Mage = 71.2) took surveys assessing Perceived Health and Affect and underwent an objective physical health assessment. Structural equation modeling was used to investigate the extent to which the relationship between Objective Health and Perceived Health was moderated by PA or NA, which would indicate the presence of affective health bias. RESULTS Results reveal a significant moderation effect for NA, but not for PA; PA appeared to serve a more mediational function, indicating that NA and PA operate on health perceptions in distinct ways. CONCLUSIONS These findings provide evidence that in our high-functioning, community-dwelling sample of older adults, a) affective health bias is present within a general health context, and not only within specific symptom or diagnostic categories; and b) that both PA and NA play important roles in the process.
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Affiliation(s)
- Brenda R Whitehead
- Behavioral Sciences Department, University of Michigan-Dearborn, 4901 Evergreen Rd., CB 4057, Dearborn, MI 48128, United States.
| | - C S Bergeman
- Department of Psychology, University of Notre Dame, 118 Haggar Hall, Notre Dame, IN 46556, United States.
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Phillips SM, Lloyd GR, Awick EA, McAuley E. Relationship between self-reported and objectively measured physical activity and subjective memory impairment in breast cancer survivors: role of self-efficacy, fatigue and distress. Psychooncology 2016; 26:1390-1399. [PMID: 27388973 DOI: 10.1002/pon.4156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 03/03/2016] [Accepted: 04/17/2016] [Indexed: 11/08/2022]
Abstract
PURPOSE Many breast cancer survivors report cancer and cancer treatment-associated cognitive change. However, very little is known about the relationship between physical activity and subjective memory impairment (SMI) in this population. The purpose of this study is to examine the relationship between physical activity and SMI and longitudinally test a model examining the role of self-efficacy, fatigue and distress as potential mediators. METHODS Post-treatment breast cancer survivors (N = 1477) completed measures of physical activity, self-efficacy, distress (depression, concerns about recurrence, perceived stress, anxiety), fatigue and SMI at baseline and 6-month follow-up. A subsample (n = 362) was randomly selected to wear an accelerometer. It was hypothesized that physical activity indirectly influences SMI via exercise self-efficacy, distress and fatigue. Relationships were examined using panel analysis within a covariance modeling framework. RESULTS The hypothesized model provided a good fit in the full sample (χ2 = 1462.5, df = 469, p = <0.001; CFI = 0.96; SRMR = 0.04) and the accelerometer subsample (χ2 = 961.8, df = 535, p = <0.001, CFI = 0.94, SRMR = 0.05) indicating increased physical activity is indirectly associated with reduction in SMI across time, via increased exercise self-efficacy and reduced distress and fatigue. CONCLUSIONS Higher levels of physical activity, lower levels of fatigue and distress and higher exercise self-efficacy may play an important role in understanding SMI in breast cancer survivors across time. Future research is warranted to replicate and explore these relationships further. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Gillian R Lloyd
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Elizabeth A Awick
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Urbana, IL, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Urbana, IL, USA
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Coutinho V, Câmara-Costa H, Kemlin I, Billette de Villemeur T, Rodriguez D, Dellatolas G. The Discrepancy between Performance-Based Measures and Questionnaires when Assessing Clinical Outcomes and Quality of Life in Pediatric Patients with Neurological Disorders. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:255-261. [DOI: 10.1080/21622965.2016.1146141] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- V Coutinho
- a Pediatric Neurology Unit , APHP, GHUEP, Trousseau Hospital , Paris , France.,b Neurofibromatosis Referral Centre , Paris , France.,c National Institute of Health and Medical Research , INSERM CESP1018 , Villejuif , France.,d Paris Descartes University , Paris , France
| | - H Câmara-Costa
- c National Institute of Health and Medical Research , INSERM CESP1018 , Villejuif , France
| | - I Kemlin
- a Pediatric Neurology Unit , APHP, GHUEP, Trousseau Hospital , Paris , France.,b Neurofibromatosis Referral Centre , Paris , France
| | - T Billette de Villemeur
- a Pediatric Neurology Unit , APHP, GHUEP, Trousseau Hospital , Paris , France.,e Sorbonne Universities, UPMC , Paris , France.,f National Institute of Health and Medical Research , INSERM U1141 , Paris , France
| | - D Rodriguez
- a Pediatric Neurology Unit , APHP, GHUEP, Trousseau Hospital , Paris , France.,b Neurofibromatosis Referral Centre , Paris , France.,e Sorbonne Universities, UPMC , Paris , France.,f National Institute of Health and Medical Research , INSERM U1141 , Paris , France
| | - G Dellatolas
- c National Institute of Health and Medical Research , INSERM CESP1018 , Villejuif , France
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Heller MK, Chapman SCE, Horne R. Beliefs about medication predict the misattribution of a common symptom as a medication side effect--Evidence from an analogue online study. J Psychosom Res 2015; 79:519-29. [PMID: 26519128 DOI: 10.1016/j.jpsychores.2015.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Some perceived medication side effects may be 'normal' symptoms that patients misattribute to the medication. Using an analogue approach, we tested if medication beliefs predict whether participants misattribute a headache as a side effect and subsequently intend to stop medication. METHODS We recruited 690 participants, 223 reporting a past asthma diagnosis. They received information about asthma and Molair, a fictitious asthma treatment modeled on a licensed treatment (montelukast). We varied the description of efficacy and side effects (which did not include headache). Pre-exposure to this information, participants completed the Beliefs about Medicine Questionnaire (BMQ)-General and the Perceived Sensitivity to Medicines Scale (PSM), post-exposure they completed the BMQ-Specific. Participants were asked to imagine they experienced a headache while taking Molair. Finally, they rated whether the headache was a side effect (misattribution) and if they would stop taking Molair (behavioral intention). RESULTS Nearly a quarter (170) of participants misattributed the headache to Molair and 69 (10%) subsequently intended to stop Molair. Both outcomes were predicted by general and specific medication beliefs. Odds of misattribution (m) and behavioral intention (i) increased with higher General Harm (ORm=1.90, ORi=2.72), General Overuse (ORm=1.74, ORi=1.56) and Molair Concern beliefs (ORm=1.52, ORi=1.78, all p<.01), but decreased with General Benefit (ORm=0.72, ORi=0.53) and Molair Necessity beliefs (ORm=0.72, ORi=0.70, all p<.05). CONCLUSION Symptom misattribution and subsequent intentions to stop Molair were predicted by pre-exposure beliefs about medicines in general and post-exposure beliefs about Molair. Patients with negative medication beliefs may be prone to misattribute symptoms and subsequently stop medication.
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Affiliation(s)
- Monika K Heller
- Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, United Kingdom
| | - Sarah C E Chapman
- Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, United Kingdom
| | - Rob Horne
- Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, United Kingdom.
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Bogaerts K, Rayen L, Lavrysen A, Van Diest I, Janssens T, Schruers K, Van den Bergh O. Unraveling the relationship between trait negative affectivity and habitual symptom reporting. PLoS One 2015; 10:e0115748. [PMID: 25603317 PMCID: PMC4300148 DOI: 10.1371/journal.pone.0115748] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 12/01/2014] [Indexed: 11/18/2022] Open
Abstract
Objective In two studies, we aimed at further elucidating the relationship between trait negative affectivity (NA) and habitual symptom reporting (HSR) by relating these variables to measures of executive function, trait questionnaires, and effects of emotion induction. Methods Healthy female participants (N = 75) were selected on their scores for trait NA and for the Checklist for Symptoms in Daily Life. Three groups were compared: (1) low NA-low HSR; (2) high NA-low HSR; and (3) high NA-high HSR (low NA-high HSR did not occur). In study 1, participants underwent a Parametric Go/No-go Task and a Stroop Color-Word test, and trait questionnaires measured alexithymia and absorption. Forty-five participants (N = 15 in each group) were further engaged in study 2 to induce state NA using an affective picture paradigm. Results Impaired inhibition on the Stroop and Go/No go Task characterized high trait NA, but not high HSR, whereas alexithymia and absorption were elevated in HSR, regardless of trait NA. Negative picture viewing induced elevated state NA in all groups, but only high HSR also reported more bodily symptoms. This effect was moderated, but not mediated by state NA. Conclusion High trait NA is a vulnerability factor but not a sufficient condition to develop HSR. Deficient inhibition is related to the broad trait of NA, whereas the moderating effect of state NA on symptom reporting is specific for high HSR. Understanding processes related to alexithymia and absorption may specifically help to explain elevated HSR.
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Affiliation(s)
| | | | - Ann Lavrysen
- Movement Control and Neuroplasticity Research Group, University of Leuven, Leuven, Belgium
| | - Ilse Van Diest
- Health Psychology, University of Leuven, Leuven, Belgium
| | | | - Koen Schruers
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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16
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The association of depression and angina pectoris across 47 countries: findings from the 2002 World Health Survey. Eur J Epidemiol 2014; 29:507-15. [DOI: 10.1007/s10654-014-9926-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 06/10/2014] [Indexed: 12/19/2022]
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17
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Merriman JD, Von Ah D, Miaskowski C, Aouizerat BE. Proposed mechanisms for cancer- and treatment-related cognitive changes. Semin Oncol Nurs 2014; 29:260-9. [PMID: 24183157 DOI: 10.1016/j.soncn.2013.08.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To review the proposed mechanisms of cognitive changes associated with non-central nervous system cancers and cancer treatment. DATA SOURCES Review and synthesis of databased publications and review articles. CONCLUSION Proposed mechanisms include cytokine upregulation, hormonal changes, neurotransmitter dysregulation, attentional fatigue, genetic predisposition, and comorbid symptoms. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses need to understand the multiple mechanisms that may contribute to the development of cancer- and treatment-related cognitive changes so that they can identify patients at high risk and help patients understand why these changes occur.
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Lai JS, Wagner LI, Jacobsen PB, Cella D. Self-reported cognitive concerns and abilities: two sides of one coin? Psychooncology 2014; 23:1133-41. [PMID: 24700645 DOI: 10.1002/pon.3522] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 02/04/2014] [Accepted: 02/24/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Patient-reported cognitive function can be measured using negatively worded items (concerns) and positively worded (abilities) items. It is possible that reporting abilities is less subject to the influence of emotional states. This study evaluated the relationship between cognitive concerns and cognitive abilities. METHODS Cancer patients (N = 509; mean age = 61 years; 50% men; 86% White) completed concerns and abilities items developed by the National Institutes of Health Patient-Reported Outcomes Information System (PROMIS). Confirmatory factor analysis was used to evaluate the extent to which items were loaded on one single factor (unidimensionality). Multidimensionality was evaluated using bi-factor analysis (local factors: concerns and abilities). Slope parameters from multidimensional item response theory (IRT) and unidimensional IRT were compared to evaluate which factor solution fits best. RESULTS Acceptable fit indices were found in both one-factor confirmatory factor analysis (comparative fit index (CFI) = 0.96; root mean squared error of approximation (RMSEA) = 0.062) and bi-factor analysis (CFI = 0.98; RMSEA = 0.043). Thus, abilities and concerns could be considered as a single dimension. Yet, high loadings on the local factor in bi-factor analysis and slope discrepancies between unidimensional IRT and multidimensional IRT indicate that abilities should be considered as a separate factor from concerns. CONCLUSIONS Concerns and abilities could be measured using one-unidimensional item bank. Results also support measuring each construct separately. We recommend a conservative approach by measuring and reporting concerns and abilities separately. We therefore recommend two separate but co-calibrated item banks in the PROMIS network: cognitive function item bank-concerns and cognitive function item bank-abilities. Both item banks showed good psychometric properties and are available for research and clinical purposes.
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Affiliation(s)
- Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Mulligan LD, Christie F, Kangura H, Pankhania M, Sambrook S, Samson H, Steadman C, Wang F, Wearden A. Negative affect is associated with reporting of both own and others’ symptoms. PSYCHOL HEALTH MED 2014; 19:738-43. [DOI: 10.1080/13548506.2013.878803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Lorduy KM, Liegey-Dougall A, Haggard R, Sanders CN, Gatchel RJ. The prevalence of comorbid symptoms of central sensitization syndrome among three different groups of temporomandibular disorder patients. Pain Pract 2013; 13:604-13. [PMID: 23336585 DOI: 10.1111/papr.12029] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/27/2012] [Accepted: 11/16/2012] [Indexed: 01/01/2023]
Abstract
AIMS Symptoms of central sensitization syndrome (CSS) were evaluated among three different groups of temporomandibular disorder (TMD) patients. Additionally, TMD group differences in pain and pain-related disability were assessed, as well as emotional distress. METHODS Participants were 250 patients with symptoms of acute TMD, recruited from dental clinics within a major metropolitan area. Sequential regressions and multivariate analyses of covariance were conducted in order to make group comparisons. RESULTS Those with a TMD Muscle Disorder (ie, myofacial TMD [m-TMD]) and those with more than one TMD diagnosis had the most symptoms of CSS and higher reports of pain and pain-related disability. Moreover, emotional distress accounted for a substantial amount of the variance for physical symptoms and mediated all TMD comparisons. CONCLUSIONS Myofacial TMD is characterized by a high degree of comorbidity of symptoms of CSS and associated emotional distress.
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Affiliation(s)
- Kara M Lorduy
- Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, Texas, U.S.A
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21
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Abstract
OBJECTIVE The present study addresses gaps in the literature on affect-biased health perceptions by (a) investigating health bias while considering both valence and arousal components of affect; (b) establishing the presence of, and variability in, affective health bias at the daily level; and (c) exploring daily health bias in a non-clinical, community sample of adults. DESIGN Participants were 477 adults (aged 33-80 years) who reported daily health events, health satisfaction and affect for up to 56 days. Health bias was present when the effect of a given day's health events on that day's health satisfaction was significantly moderated by that day's affect. Multilevel modelling was used to investigate fixed and random within-day effects. MAIN OUTCOME MEASURE Daily health satisfaction. RESULTS Significant interaction effects indicated the presence of health bias on the daily level: positively valenced affect buffered the negative impact of health events on health satisfaction, whereas negatively valenced affect exacerbated this association; additionally, valence emerged as the most salient characteristic of positive affect, whereas arousal was a differentiating factor for negative affect. CONCLUSION The results provide evidence that both valence and arousal components of affect are important to consider when investigating day-level health bias, and that these effects can be detected using a general population of adults.
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Affiliation(s)
- Brenda R Whitehead
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA.
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22
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Loerbroks A, Jiang CQ, Thomas GN, Adab P, Zhang WS, Lam KBH, Bosch JA, Cheng KK, Lam TH. COPD and Depressive Symptoms: Findings from the Guangzhou Biobank Cohort Study. Ann Behav Med 2012; 44:408-15. [DOI: 10.1007/s12160-012-9389-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Falzer PR, Leventhal HL, Peters E, Fried TR, Kerns R, Michalski M, Fraenkel L. The practitioner proposes a treatment change and the patient declines: what to do next? Pain Pract 2012; 13:215-26. [PMID: 23462141 DOI: 10.1111/j.1533-2500.2012.00573.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study describes how pain practitioners can elicit the beliefs that are responsible for patients' judgments against considering a treatment change and activate collaborative decision making. METHODS Beliefs of 139 chronic pain patients who are in treatment but continue to experience significant pain were reduced to 7 items about the significance of pain on the patient's life. The items were aggregated into 4 decision models that predict which patients are actually considering a change in their current treatment. RESULTS While only 34% of study participants were considering a treatment change overall, the percentage ranged from 20 to 70, depending on their ratings about current consequences of pain, emotional influence, and long-term impact. Generalized linear model analysis confirmed that a simple additive model of these 3 beliefs is the best predictor. CONCLUSION Initial opposition to a treatment change is a conditional judgment and subject to change as specific beliefs become incompatible with patients' current conditions. These beliefs can be elicited through dialog by asking 3 questions.
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Affiliation(s)
- Paul R Falzer
- Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA.
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24
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Suls J, Howren MB. Understanding the Physical-Symptom Experience. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2012. [DOI: 10.1177/0963721412439298] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Individuals tend to believe that the somatic sensations they are currently experiencing or have experienced accurately reflect their physical functioning; however, the experience of somatic symptoms is also affected by psychological and social factors. For two decades, the dominant perspective has been that the general tendency to experience negative emotions—negative affectivity (NA; also known as neuroticism or negative emotionality)—inflates physical-symptom reporting because persons high in NA are more likely to notice somatic changes and to label even minor or benign somatic changes as signs of illness. We review recent research suggesting that two components of NA—anxiety and depression, which are associated with distinctive cognitive-affective biases related to attention/encoding and recall, respectively—are more critical for the cognitive processing of somatic changes than is global NA per se. Specifically, anxiety is responsible for elevated reports of momentary symptoms, whereas depression is related to exaggerated recall of past symptoms. Understanding the distinctive roles of anxiety and depression in the experience of physical symptoms has implications for researchers and practitioners in the fields of personality, clinical science, health psychology, psychiatry, cognitive and affective neuroscience, and medicine.
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Janssens T, Verleden G, De Peuter S, Petersen S, Van den Bergh O. Predicting asthma treatment outcome at diagnosis: the role of symptom perception during a histamine challenge test. J Asthma 2012; 49:230-6. [PMID: 22316110 DOI: 10.3109/02770903.2012.656864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In asthma, many treatment decisions are dependent upon patient perception/patient report of asthma symptoms. Discrepancies between patient perception of asthma symptoms and objective indicators of pathophysiology are widespread and can hinder asthma treatment. Early detection of problems in asthma symptom perception may be a first step to help these patients. We investigated the predictive value of symptom perception during a histamine challenge test (HCT) at asthma diagnosis for patient-rated outcome of asthma treatment 3 months later. METHODS In a prospective observational study, persons with asthma (N = 60) showing bronchial hyperresponsiveness in a HCT completed questions on asthma symptoms and negative affectivity (NA). The HCT was extended with an ambiguous situation suggesting asthma symptoms despite physiological recovery. Lung function (forced expiratory volume in 1 second (FEV(1))) and symptom ratings were measured during the test (after each histamine dosage), and we constructed several measures of asthma symptom perception based on FEV(1) and symptom ratings. Three months later, 30 participants completed questionnaires on asthma control and asthma-related quality of life. RESULTS Symptoms reported during HCT predicted worse asthma control and quality of life 3 months later. The prospective association between symptoms during HCT and asthma control remained significant when controlling for NA and baseline lung function. These effects were strongest for symptoms during ambiguous situations. CONCLUSIONS Higher symptom levels at the start of the HCT and during recovery may reflect a tendency to inaccurately perceive asthma symptoms in ambiguous situations. Assessing symptoms during diagnostic challenge tests can help predict problems with asthma treatment.
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Affiliation(s)
- Thomas Janssens
- Health Psychology Research Unit, University of Leuven, Leuven, Belgium.
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Hermelink K, Küchenhoff H, Untch M, Bauerfeind I, Lux MP, Bühner M, Manitz J, Fensterer V, Münzel K. Two different sides of ‘chemobrain’: determinants and nondeterminants of self-perceived cognitive dysfunction in a prospective, randomized, multicenter study. Psychooncology 2010; 19:1321-8. [PMID: 20127909 DOI: 10.1002/pon.1695] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kerstin Hermelink
- Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany.
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Kaptein AA, Klok T, Moss-Morris R, Brand PLP. Illness perceptions: impact on self-management and control in asthma. Curr Opin Allergy Clin Immunol 2010; 10:194-9. [PMID: 20386435 DOI: 10.1097/aci.0b013e32833950c1] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Outcome in asthma is determined not only by pulmonary function or other biomedical characteristics. An important determinant of asthma outcome is illness perceptions: patients' subjective beliefs and emotional responses to their illness. Illness perceptions influence patients' coping and self-management behavior, and thereby outcome. RECENT FINDINGS We review recent studies on associations between illness perceptions and outcome in patients with asthma, with a range of respondents and caregivers, with varying degree of asthma severity, and in different settings of medical care. Most studies pertain to substantial numbers of patients, and have been performed in different countries, adding to the external validity of the findings. All studies report substantial effects of illness perceptions on various categories of outcome: illness perceptions reflecting personal control over the illness are associated with a positive outcome, that is, asthma control. Findings point at the importance and clinical relevance of addressing patients' illness perceptions, and suggest that this may improve outcome in asthma care. Well conducted intervention studies on this topic are called for in order to improve outcomes and quality of life in asthma patients. SUMMARY Illness perceptions influence the way in which patients with asthma cope and their self-management of the illness. Illness perceptions can be assessed quite easily and directly, they inform healthcare providers about the psychosocial responses of patients towards their asthma, they are responsive to change in the clinical encounter or via self-management intervention training. Exploring patient's illness perceptions, therefore, is a crucial component of good clinical care.
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Affiliation(s)
- Ad A Kaptein
- Medical Psychology, Leiden University Medical Center (LUMC), Leiden, The Netherlands. a.a.kaptein@ lumc.nl
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Skovbjerg S, Zachariae R, Rasmussen A, Johansen JD, Elberling J. Repressive coping and alexithymia in idiopathic environmental intolerance. Environ Health Prev Med 2010; 15:299-310. [PMID: 21432559 DOI: 10.1007/s12199-010-0143-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Accepted: 03/23/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To examine if the non-expression of negative emotions (i.e., repressive coping) and differences in the ability to process and regulate emotions (i.e., alexithymia) is associated with idiopathic environmental intolerance (IEI). METHODS The study included participants who had previously participated in a general population-based study and reported symptoms of environmental intolerance (n = 787) and patients with IEI (n = 237). The participants completed questionnaires assessing IEI, namely, a measure of repressive coping combining scores on the Marlowe-Crowne Social Desirability Scale (MCSDS) and the Taylor Manifest Anxiety Scale (TMAS), the Toronto Alexithymia Scale (TAS-20), and a negative affectivity scale (NAS). Multiple, hierarchical linear regression analyses were conducted using IEI variables as the dependent variables. RESULTS The TMAS and MCSDS scores were independently associated with the IEI variables, but there was no evidence of a role of the repressive coping construct. While the total alexithymia score was unrelated to IEI, the TAS-20 subscale of difficulties identifying feelings (DIF) was independently associated with symptoms attributed to IEI. Negative affectivity was a strong independent predictor of the IEI variables and a mediator of the association between DIF and IEI. CONCLUSION Our results provide no evidence for a role of repressive coping in IEI, and our hypothesis of an association with alexithymia was only partly supported. In contrast, strong associations between IEI and negative emotional reactions, defensiveness and difficulties identifying feelings were found, suggesting a need for exploring the influence of these emotional reactions in IEI.
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Affiliation(s)
- Sine Skovbjerg
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Ledreborg Alle 40, 2.th, 2820, Gentofte, Denmark.
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Mora PA, Contrada RJ, Berkowitz A, Musumeci-Szabo T, Wisnivesky J, Halm EA. Measurement invariance of the Mini Asthma Quality of Life Questionnaire across African-American and Latino adult asthma patients. Qual Life Res 2009; 18:371-80. [PMID: 19221893 DOI: 10.1007/s11136-009-9443-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 01/21/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE This study tested the factorial and measurement invariance of the Mini Asthma Quality of Life Questionnaire (MiniAQLQ) in a sample of Latino and African-American asthmatic patients. METHODS We used confirmatory factor analyses (CFA) to examine data from adult outpatients diagnosed with asthma (n = 265). We proceeded by examining the original factor structure of the MiniAQLQ in the whole sample. We then determined whether the factor structure supported by the data was invariant across African-American and Latino patients by testing a series of nested models. RESULTS Results revealed that a three-factor structure model that combined the emotional function and symptom domains had the best fit to the whole sample (chi (2)(91) = 99.83, P = 0.08). Analysis using a MIMIC model among Latino participants indicated that survey language did not influence item functioning (chi (2)(93) = 103.29, P = 0.22). Multi-group CFA showed that both the structure and the meaning of the items were invariant across Africa-American and Latino participants. Scalar and strict measurement invariance was supported for 11 out of 15 items. CONCLUSION These data suggest that structure of the MiniAQLQ needs to be reassessed. Additional research needs to examine whether elimination of current items or inclusion of new items can ensure that constructs are measured without bias across different ethnic groups.
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Affiliation(s)
- Pablo A Mora
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA.
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Bogaerts K, Millen A, Li W, De Peuter S, Van Diest I, Vlemincx E, Fannes S, Van den Bergh O. High symptom reporters are less interoceptively accurate in a symptom-related context. J Psychosom Res 2008; 65:417-24. [PMID: 18940371 DOI: 10.1016/j.jpsychores.2008.03.019] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Revised: 03/11/2008] [Accepted: 03/18/2008] [Indexed: 12/29/2022]
Abstract
OBJECTIVE We investigated the role of a symptom interpretation frame on the accuracy of interoception and on retrospective symptom reporting in nonclinical high and low reporters of medically unexplained symptoms. METHODS All participants (N=74) went through two subsequent trials of the Rebreathing Test, inducing altered respiration and other physical sensations as a result of a gradually increasing pCO(2) level in the blood. Each trial consisted of a baseline (60 s), a rebreathing phase (150 s), and a recovery phase (150 s). In one trial, the sensations were framed in a neutral way ("the gas mixture might alter breathing behavior and induce respiratory sensations"). In the other trial, a symptom frame was induced ("the gas mixture might alter breathing behavior and induce respiratory symptoms"). Breathing behavior was continuously monitored, subjective sensations were rated every 10 s, and after each trial, participants filled out a symptom checklist. Within-subject correlations between the subjective rating and its physiological referent were calculated for the rebreathing phase and recovery phase of each trial separately. RESULTS High symptom reporters had more (retrospective) complaints than low symptom reporters, especially in the symptom trial. Only in the symptom frame were high symptom reporters less accurate than low symptom reporters. The reduction in interoceptive accuracy (IA) in high symptom reporters was most striking in the recovery phase of the symptom frame trial. CONCLUSION A contextual cue, such as a reference to symptoms, reduced IA in high symptom reporters and this was more so during recovery from the symptom induction.
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Psychological Factors Influencing Self-Assessments of Health: Toward an Understanding of the Mechanisms Underlying How People Rate Their Own Health. Ann Behav Med 2008; 36:292-303. [DOI: 10.1007/s12160-008-9065-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Indexed: 10/21/2022] Open
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Leventhal H, Weinman J, Leventhal EA, Phillips LA. Health Psychology: the Search for Pathways between Behavior and Health. Annu Rev Psychol 2008; 59:477-505. [PMID: 17937604 DOI: 10.1146/annurev.psych.59.103006.093643] [Citation(s) in RCA: 182] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review of the current status of theoretically based behavioral research for chronic illness management makes the following points: (a) Behavioral interventions have demonstrated effectiveness for improving health outcomes using biomedical indicators, (b) current interventions are too costly and time consuming to be used in clinical and community settings, (c) translation of the conceptual models generated from studies of the problem-solving processes underlying self-management and the relationship of these processes to the self system and cultural and institutional contexts suggest new avenues for developing effective and efficient cognitive-behavioral interventions, and (d) it is proposed that integration of the conceptual developments in self-management with new approaches to the design of clinical trials can generate tailored, behavioral interventions that will improve quality of care.
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Affiliation(s)
- Howard Leventhal
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey 08901-1293, USA.
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McAndrew LM, Musumeci-Szabó TJ, Mora PA, Vileikyte L, Burns E, Halm EA, Leventhal EA, Leventhal H. Using the common sense model to design interventions for the prevention and management of chronic illness threats: from description to process. Br J Health Psychol 2008; 13:195-204. [PMID: 18331667 DOI: 10.1348/135910708x295604] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this article, we discuss how one might use the common sense model of self-regulation (CSM) for developing interventions for improving chronic illness management. We argue that features of that CSM such as its dynamic, self-regulative (feedback) control feature and its system structure provide an important basis for patient-centered interventions. We describe two separate, ongoing interventions with patients with diabetes and asthma to demonstrate the adaptability of the CSM. Finally, we discuss three additional factors that need to be addressed before planning and implementing interventions: (1) the use of top-down versus bottom-up intervention strategies; (2) health care interventions involving multidisciplinary teams; and (3) fidelity of implementation for tailored interventions.
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Affiliation(s)
- Lisa M McAndrew
- Center for the Study of Health Beliefs and Behavior, Institute for Health, Rutgers, the State University of New Jersey, New Brunswick, NJ 08901, USA
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