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Macía P, Gorbeña S, Barranco M, Iglesias N, Iraurgi I. A global health model integrating psychological variables involved in cancer through a longitudinal study. Front Psychol 2022; 13:873849. [PMID: 35967626 PMCID: PMC9366101 DOI: 10.3389/fpsyg.2022.873849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe literature has shown the relevance of certain psychological variables in adjustment to cancer. However, there is a great variability, and these features could be modified through the disease process. The aim of this study is to provide an integrated and global perspective of the importance of variables such as coping, resilience, emotional control, social support, affect, and others in cancer patients through a longitudinal study, with the objective of exploring their associations and underlying interactions.MethodsThe sample was composed of 71 people diagnosed with cancer who were attending psychological support at the Spanish Association Against Cancer (Biscay). We assessed the following variables in two periods of 6 months: perceived stress (PSS), emotional control (CECS), resilience (CD-RISC), coping strategies (CERQ), personality (NEOFFI), social support (MOSS), affect (PANAS), emotional distress (GHQ), quality of life (SF-12) and visual-analogic scales (EVA).ResultsResults showed predictive effects of perceived stress on physical health perception (β = −0.22; t = −3.26; p = 0.002). Mental health perception was influenced by almost all the psychological variables. Consciousness at baseline (βCo = 0.15; p = 0.003), change in Extraversion (βEx = 0.16; p = 0.001) and Resilience (βRe = 0.15; p = 0.002) had significant effects on perceived mental health.ConclusionThis study provides a global health model that integrates and explores associations between psychological variables related to cancer disease. This information could be useful for guiding personalized psychotherapeutic interventions, with the aim of increasing adjustment to disease.
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Affiliation(s)
- Patricia Macía
- Faculty of Psychology, University of Basque Country, UPV/EHU, San Sebastian, Spain
- *Correspondence: Patricia Macía,
| | - Susana Gorbeña
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | | | - Nerea Iglesias
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Ioseba Iraurgi
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
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2
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Wojciechowska I, Matkowski R, Pawłowski T. Type D Personality and Big Five Personality Traits and the Risk of Breast Cancer: A Case-Control Study. Front Psychiatry 2022; 13:723795. [PMID: 35273526 PMCID: PMC8902144 DOI: 10.3389/fpsyt.2022.723795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The goal of this study is to establish the differences in Type D personality and Big five personality traits between a group of newly diagnosed breast cancer patients and a group of controls. METHODS A comparative study of breast cancer patients and women without previous history of cancer was carried out. We used Type D Scale-14 as an instrument for the assessment of the type-D personality pattern and NEO-FFI for the assessment of the Big Five personality traits. Conditional logistic regression models were used to estimate odds ratios and 95% confidence intervals were applied for breast cancer by personality trait factors. RESULTS Negative affectivity (NA) (OR = 4.45 95% CI: 1.96-10.61), neuroticism HIGH (OR = 3.97, 95% CI: 1.08-15.81), openness to experience HIGH (OR = 3.47 95% CI: 1.11-11.49), were associated factors significantly related to an increased risk of breast cancer, whereas Social Inhibition (SI) was associated factor with a decreased risk of breast cancer (OR = 0.40 95% CI: 0.16-0.92). CONCLUSIONS This was the first case-control study which analyzed NA and SI traits in breast cancer patients. SI as a breast-cancer risk decreasing factor might indicate that expressing negative emotions is not always a healthy mechanism of their regulation.
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Affiliation(s)
- Irena Wojciechowska
- Division of Psychotherapy and Psychosomatic Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Matkowski
- Wroclaw Comprehensive Cancer Center, Wroclaw, Poland.,Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Pawłowski
- Division of Psychotherapy and Psychosomatic Medicine, Wroclaw Medical University, Wroclaw, Poland
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3
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Grassi L, Caruso R, Murri MB, Fielding R, Lam W, Sabato S, De Padova S, Nanni MG, Bertelli T, Palagini L, Zerbinati L. Association between Type-D Personality and Affective (Anxiety, Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study. Clin Pract Epidemiol Ment Health 2021; 17:271-279. [PMID: 35444709 PMCID: PMC8985468 DOI: 10.2174/1745017902117010271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/26/2021] [Accepted: 10/12/2021] [Indexed: 11/22/2022]
Abstract
Background: Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients. Objective: The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up). Aims: The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients. Methods: 145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1. Results: One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1. Conclusion: Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.
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4
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Galli F, Scotto L, Ravenda S, Zampino MG, Pravettoni G, Mazzocco K. Personality Factors in Colorectal Cancer: A Systematic Review. Front Psychol 2021; 12:590320. [PMID: 34803785 PMCID: PMC8595914 DOI: 10.3389/fpsyg.2021.590320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/06/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The role of personality in cancer incidence and development has been studied for a long time. As colorectal cancer (CRC) is one of the most prevalent cancer types and linked with lifestyle habits, it is important to better understand its psychological correlates, in order to design a more specific prevention and intervention plan. The aim of this systematic review is to analyze all the studies investigating the role of personality in CRC incidence. Methods: All studies on CRC and personality up to November 2020 were scrutinized according to the Cochrane Collaboration and the PRISMA statements. Selected studies were additionally evaluated for the Risk of Bias according to the Newcastle-Ottawa Scale (NOS). Results: Eight studies met the inclusion criteria and were eventually included in this review. Two main constructs have been identified as potential contributors of CRC incidence: emotional regulation (anger) and relational style (egoism). Conclusion: Strong conclusions regarding the influence of personality traits on the incidence of CRC are not possible, because of the small number and the heterogeneity of the selected studies. Further research is needed to understand the complexity of personality and its role in the incidence of CRC and the interaction with other valuable risk factors.
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Affiliation(s)
- Federica Galli
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Ludovica Scotto
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
| | - Simona Ravenda
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Maria Giulia Zampino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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5
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Kreitler S, Kreitler H. The psychological profile of the health‐oriented individual. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.2410050104] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study was designed to explore the psychological characteristics of individuals who score high on a measure assessing health orientation. The measure was constructed in the framework of the cognitive orientation theory and consists of beliefs of four types (about goals, rules and norms, oneself, and general) referring to themes such as trusting people, control, and enjoyment. The subjects were 176 healthy adults (88 men, 88 women) in the age range 31‐50 (M = 39.4 years) examined in the framework of a health survey. They were administered the Cognitive Orientation of Health Questionnaire and other measures assessing emotions, authoritarianism, locus of control, daydreaming, repressiveness, neuroticism, somatic complaints, somatization, and alexithymia. The main results obtained by ANOVA and multiple regression analyses were that high‐scorers on health orientation also scored higher on love, joy, contentment, hostility, jealousy (men only), emotional reactions, positive daydreams, internal control, repressiveness, neuroticism, functional‐actional self‐descriptions, and negative selfreferences. High‐scorers on health orientation scored lower on depression, anxiety, fear, jealousy (women only), negative daydreams, poor attentional control, somatic complaints, somatization, alexithymia, positive self‐references, and self‐descriptions that capitalize on body parts, weight, and appearance. The major conclusions refer to the conception of a psychological general health orientation and its manifestations.
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Rymarczyk K, Turbacz A, Strus W, Cieciuch J. Type C Personality: Conceptual Refinement and Preliminary Operationalization. Front Psychol 2020; 11:552740. [PMID: 33041918 PMCID: PMC7525034 DOI: 10.3389/fpsyg.2020.552740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/20/2020] [Indexed: 12/24/2022] Open
Abstract
In this paper, we have presented our proposal for reconceptualization and operationalization of Type C (cancer-prone) personality. Based on theoretical analyses, taking into account both the literature on Type C and models of personality structure, we have proposed a two-facet structure of Type C, comprising Submissiveness (the interpersonal aspect) and Restricted Affectivity (the intrapersonal aspect). The study devoted to the validation of the measure of Type C involved 232 participants aged 18-70 (M = 29.35, SD = 8.93; 54% male). We used (a) our proposed measure of Type C personality and (b) the Circumplex of Personality Metatraits Questionnaire (CPM-Q-SF; Strus and Cieciuch, 2017), assessing personality metatraits. The measure of Type C proved to have acceptable internal consistency (Cronbach's alpha was 0.85 for Submissiveness and 0.78 for Restricted Affectivity). The measurement model in confirmatory factor analysis with two latent variables proved to be well-fitted to the data. We have also confirmed the hypothesis concerning the location of the two facets of Type C personality close to each other in the theoretically predicted area between the Delta-Plus/Self-Restraint and Beta-Minus/Passiveness metatraits (in the Circumplex of Personality Metatraits). The clinical value of the theoretically refined Type C can be tested in the next step in research on patients with cancer.
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Affiliation(s)
- Karolina Rymarczyk
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Anna Turbacz
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Włodzimierz Strus
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Jan Cieciuch
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
- URPP Social Networks University of Zurich, Zurich, Switzerland
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7
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Macía P, Gorbeña S, Barranco M, Alonso E, Iraurgi I. Role of resilience and emotional control in relation to mental health in people with cancer. J Health Psychol 2020; 27:211-222. [PMID: 32783467 PMCID: PMC8739566 DOI: 10.1177/1359105320946358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This study explored the relationship between emotional control, resilience, and mental health in cancer. Patients with cancer were recruited (n = 170). Courtauld Scale of Emotional Control, Connor-Davidson Resilience Scale, and the General Health Questionnaire were selected. Assuming the absence of interaction among the variables, they were analyzed separately. Four groups resulted, finding statistically significant differences (F(4, 165) = 18.03; p < 0.001). High resilience and low emotional control seem to be protective attributes, and high emotional control has demonstrated to be a risk factor for mental health. Considering differences in cancer-related psychological variables could derive in personalized psychotherapeutic interventions.
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Affiliation(s)
- Patricia Macía
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology and Education, University of Deusto, Bilbao (Biscay), Spain
| | - Susana Gorbeña
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology and Education, University of Deusto, Bilbao (Biscay), Spain
| | - Mercedes Barranco
- Spanish Association Against Cancer, Provincial Office of Biscay, Spain
| | - Estibaliz Alonso
- Spanish Association Against Cancer, Provincial Office of Biscay, Spain
| | - Ioseba Iraurgi
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology and Education, University of Deusto, Bilbao (Biscay), Spain
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8
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Macía P, Gorbeña S, Gómez A, Barranco M, Iraurgi I. Role of neuroticism and extraversion in the emotional health of people with cancer. Heliyon 2020; 6:e04281. [PMID: 32671245 PMCID: PMC7339056 DOI: 10.1016/j.heliyon.2020.e04281] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/12/2020] [Accepted: 06/19/2020] [Indexed: 12/18/2022] Open
Abstract
The impact that cancer disease can have on individuals varies depending, among other things, on their personal characteristics, so it is important to explore aspects such as the personality traits in relation to mental health in people with cancer. The aim of this study was to analyse the relationship between neuroticism, extraversion and mental health in people with cancer. Besides, this study also explored differences in mental health when combining extraversion and neuroticism levels. One hundred and seventy people who had been diagnosed with different types of cancer (breast cancer, lung, colon, gynaecological cancer and others) composed the sample. Almost all of them (92.9%) had received oncological treatment. The GHQ-12 scale was used to assess the mental health and the 60-item NEO Five-Factor Inventory was applied in order to measure neuroticism and extraversion in participants. A hierarchic lineal regression model was conducted. Neuroticism and extraversion did not show any interaction effect, although a partial mediation was observed in relation to mental health outcomes. Given the significant correlation between neuroticism and extraversion with mental health (r = .59, p < .001; r = −.41, p < .001), both personality traits were combined, resulting in a classification of four different personality profiles (F(4;165) = 19.85; p < .001). Results in this study have shown that low levels of neuroticism and high levels of extraversion are related to positive health outcomes. They seem to be protective factors with respect to the mental health in people with cancer. The knowledge of the positive effects of these aspects contributes to the comprehension of mental health in the oncological sample, which should be considered in order to design and guide particular therapeutic interventions adapted to each person.
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Affiliation(s)
- Patricia Macía
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology and Education, University of Deusto, Bilbao, Biscay, Spain
| | - Susana Gorbeña
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology and Education, University of Deusto, Bilbao, Biscay, Spain
| | - Amaia Gómez
- Spanish Association Against Cancer (Biscay Office), Bilbao, Spain
| | | | - Ioseba Iraurgi
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology and Education, University of Deusto, Bilbao, Biscay, Spain
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9
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Brown RL, Shahane AD, Chen MA, Fagundes CP. Cognitive reappraisal and nasal cytokine production following experimental rhinovirus infection. Brain Behav Immun Health 2019; 1. [PMID: 32140685 PMCID: PMC7057831 DOI: 10.1016/j.bbih.2019.100012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Following exposure to the common cold (i.e., rhinovirus), locally produced nasal cytokines (rather than the infection itself) drive the progression of one's symptoms (Hendley et al., 1973; Cohen et al., 1999). Stress-induced local inflammation exacerbates local cytokine production (e.g., marital hostility; Kiecolt-Glaser et al., 2005). An individual's ability to effectively manage their emotions is a critical component of positive health and well-being. Here, we evaluated whether one's self-reported frequency of cognitive reappraisal, an adaptive emotion regulation strategy, predicts nasal cytokine production following experimental rhinovirus exposure. Emotion regulation strategies were assessed at baseline prior to experimental infection. After the baseline assessment, each participant was exposed to a strain of rhinovirus (RV-39) and followed for 5 days in quarantine. Nasal interleukin (IL)-1β, IL-6, and IL-8 and subjective symptoms were assessed at baseline and on each of the 5 days of quarantine. A multilevel analysis of the data for 159 participants with documented infection demonstrated that less frequent use of cognitive reappraisal predicted heightened production of the nasal cytokine composite. Those who self-reported using cognitive reappraisal strategies less frequently displayed elevated nasal IL-6 and IL-8. Among the 63 participants with clinical cold, less frequent use of cognitive reappraisal was associated with heightened production of nasal IL-1β, IL-6, and IL-8. In ancillary analyses, the composite of nasal cytokines was associated with the severity of one's subjective symptoms across the 5 days. Findings suggest that emotion regulation strategies, particularly cognitive reappraisal, influence illness trajectories during rhinovirus infection.
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Affiliation(s)
- Ryan L Brown
- Rice University, 6100 Main Street, Houston, TX, 77005, United States
| | | | - Michelle A Chen
- Rice University, 6100 Main Street, Houston, TX, 77005, United States
| | - Christopher P Fagundes
- Rice University, 6100 Main Street, Houston, TX, 77005, United States.,The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, United States.,Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, United States
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10
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Shahane AD, Denny BT. Predicting emotional health indicators from linguistic evidence of psychological distancing. Stress Health 2019; 35:200-210. [PMID: 30623579 DOI: 10.1002/smi.2855] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 12/09/2018] [Accepted: 12/14/2018] [Indexed: 11/11/2022]
Abstract
Psychological distancing, a form of cognitive reappraisal, involves construal of emotionally valenced stimuli in an objective manner, or with perceived spatial and temporal distance. Prior work suggests that in appropriate contexts, reappraisal broadly, and distancing specifically, is related to adaptive mental and physical health outcomes. Additionally, recent research suggests that shifting language to be more distant (i.e., linguistic distancing [LD]) can have adaptive emotion regulatory effects. The present study addressed whether LD is also associated with adaptive health indicators. Participants transcribed their thoughts while viewing negative or neutral stimuli in one of three ways: (a) by implementing objective language, (b) by implementing spatially and/or temporally far away language, or (c) by responding naturally. Across psychological distancing groups, LD was associated with lower negative affectivity (lower perceived stress and depression symptoms), better general well-being (better emotional well-being and energy and vitality), and better emotion regulation (ER; greater reappraisal frequency and fewer difficulties in implementing ER). Participants who used more LD in the objective group had lower negative affectivity, better general well-being, and better ER, and those in the far group had better ER. The results reveal linguistic mechanisms underlying ER and its relationship to health indicators, suggesting future examination of LD interventions.
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Affiliation(s)
- Anoushka D Shahane
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
| | - Bryan T Denny
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
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Abstract
This study extends the operational definition of repression (proposed by Weinberger and his colleagues) to negative emotions other than anxiety. It then relates this measure to the responses to cancer of 67 male and female patients. Repressors differed from patients with other coping styles; they reported fewer and less severe side effects of treatment and less information exchange (communication) with significant others. These findings are discussed in relation to other research on differences in the way people tolerate and report physical sensations.
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Emotional Suppression and Breast Cancer: Validation Research on the Spanish Adaptation of the Courtauld Emotional Control Scale (CECS). SPANISH JOURNAL OF PSYCHOLOGY 2013; 13:406-17. [DOI: 10.1017/s1138741600003966] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emotional suppression has played an important role in the research on psychosocial factors related to cancer. It has been argued to be an important psychological factor predicting worse psychosocial adjustment in people with cancer and it may mediate health outcomes. The reference instrument in the research on emotional suppression is the Courtauld Emotional Control Scale (CECS). The present study analysed construct validity of a new Spanish adaptation of the CECS in a sample of 175 breast cancer patients. The results confirmed the proposal by Watson and Greer claiming that the CECS is composed of three subscales that measure different dimensions, but not independent, from emotional control. The present Spanish version of the CECS showed high internal consistency in each subscale as well as the total score. According to Derogatis (BSI-18) criteria, emotional suppression predicts clinically significant distress. In short, our results support the reliability, validity and utility of this Spanish adaptation of the CECS in clinical and research settings.
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13
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Communicative genes in the evolution of empathy and altruism. Behav Genet 2011; 41:876-88. [PMID: 21380545 DOI: 10.1007/s10519-011-9456-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 02/16/2011] [Indexed: 10/18/2022]
Abstract
This paper discusses spontaneous communication and its implications for understanding empathy and altruism. The question of the possibility of "true" altruism-giving up one's genetic potential in favor of the genetic potential of another-is a fundamental issue common to the biological, behavioral, and social sciences. Darwin regarded "social instincts and sympathies" to be critical to the social order, but the possibility of biologically-based prosocial motives and emotions was questioned when selection was interpreted as operating at the level of the gene. In the selfish gene hypothesis, Dawkins argued that the unit of evolutionary selection must be an active, germ-line replicator: a unit whose activities determine whether copies of it are made across evolutionary timescales. He argued that the only active replicator existing across evolutionary timescales is the gene, so that the "selfish gene" is a replicator motivated only to make copies of itself. The communicative gene hypothesis notes that genes function by communicating, and the phenotype communication involves not only the individual sending and receiving abilities of the individual genes involved, but also the relationship between them relative to other genes. Therefore the selection of communication as phenotype involves the selection of individual genes and also their relationship. Relationships become replicators, and are selected across evolutionary timescales including social relationships (e.g., sex, nurturance, dominance-submission). An interesting implication of this view: apparent altruism has been interpreted by selfish gene theorists as due to kin selection and reciprocity, in which the survival of kin and comrade indirectly favor the genetic potential of the altruist. From the viewpoint of the communicative gene hypothesis, rather than underlying altruism, kin selection and reciprocity are ways of restricting altruism to kin and comrade: they are mechanisms not of altruism but of xenophobia.
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Schlatter MC, Cameron LD. Emotional Suppression Tendencies as Predictors of Symptoms, Mood, and Coping Appraisals During AC Chemotherapy for Breast Cancer Treatment. Ann Behav Med 2010; 40:15-29. [DOI: 10.1007/s12160-010-9204-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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15
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Abstract
Mind-body medicine, grounded in a respectful, therapeutic partnership, should be a central element in the care of every person diagnosed with cancer. This article reviews some of the physiologic foundations of mind-body medicine, the introduction of mind-body approaches to cancer care in the 1970s, the specific mind-body approaches that have been used, and the evidence that supports their use. The importance of group support for enhancing the effectiveness of these approaches is discussed. Guidelines are offered for integrating mind-body approaches and perspectives in the care of people who have cancer.
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Affiliation(s)
- James S Gordon
- The Center for Mind-Body Medicine, 5225 Connecticut Avenue NW, Suite 414, Washington, DC 20015, USA.
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16
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Gillanders S, Wild M, Deighan C, Gillanders D. Emotion regulation, affect, psychosocial functioning, and well-being in hemodialysis patients. Am J Kidney Dis 2008; 51:651-62. [PMID: 18371541 DOI: 10.1053/j.ajkd.2007.12.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Accepted: 12/17/2007] [Indexed: 02/05/2023]
Abstract
BACKGROUND Emotion regulation refers to the psychological strategies people use to cope with such stressors as hemodialysis therapy. These strategies are associated with a range of physical and psychological variation that may be related to kidney disease and its management. This study explores the associations of 2 emotion regulation strategies, reappraisal and suppression, and considers their impact on patient well-being and kidney disease management. STUDY DESIGN Cross-sectional study. SETTING AND PARTICIPANTS 106 hemodialysis patients undergoing renal replacement therapy and 94 friends or relatives. PREDICTORS Reappraisal and suppression, measured by using the Emotion Regulation Questionnaire. OUTCOMES Outcome parameters were measures of affect, psychosocial functioning, and well-being, measured using the Positive and Negative Affect Scale, the Brief COPE questionnaire, the Kidney Disease Quality-of-Life Short Form, and the Brief Symptom Inventory. RESULTS The Emotion Regulation Questionnaire measured reappraisal and suppression. Greater use of reappraisal was associated with lower levels of anxiety (r = -0.22; P = 0.03) and greater acceptance of the disease (r = 0.20; P = 0.04). It was also associated with more experience (r = 0.26; P < 0.01) and expression (r = 0.23; P = 0.02) of positive emotion and less experience (r = -0.35; P < 0.01) and expression (r = -0.29; P < 0.01) of negative emotion. Suppression was associated with less positive emotional expression (r = -0.28; P < 0.01), greater levels of depression (r = 0.22; P = 0.03) and somatization (r = 0.25; P < 0.01), and greater dissatisfaction with the time spent dealing with their kidney disease (r = -0.21; P = 0.04). Suppression also was associated with less emotional coping (r = -0.29; P < 0.01) and greater dissatisfaction with the support received from other people (r = -0.34; P < 0.01). LIMITATIONS The study focuses on emotion regulation strategies and well-being rather than clinical parameters; therefore, extensive medical data were not recorded. CONCLUSION Reappraisal has more positive clinical and psychosocial associations than suppression. The emotion regulation strategy used by hemodialysis patients has important implications for well-being and disease management.
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Krupski TL, Litwin MS. Medical and Psychosocial Issues in Prostate Cancer Survivors. Oncology 2007. [DOI: 10.1007/0-387-31056-8_107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Edelman S, Kidman AD. Mind and cancer: Is there a relationship? — A review of evidence. AUSTRALIAN PSYCHOLOGIST 2007. [DOI: 10.1080/00050069708257358] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lehto US, Ojanen M, Dyba T, Aromaa A, Kellokumpu-Lehtinen P. Baseline psychosocial predictors of survival in localized melanoma. J Psychosom Res 2007; 63:9-15. [PMID: 17586333 DOI: 10.1016/j.jpsychores.2007.01.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2005] [Revised: 01/02/2007] [Accepted: 01/04/2007] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There is no certainty about the contributing factors or the psychological processes involved in cancer progression. Many studies have suffered from poor theoretical basis, methodological flaws, and only one or few psychosocial factors investigated at a time. We examined the simultaneous contribution of several theory-based psychosocial elements to survival time in melanoma. METHODS A consecutive sample of patients with localized (Clarke II-IV) melanoma (N=59) were evaluated with validated questionnaires on coping with cancer, anger expression, perceived social support, noncancer life stresses, and domains of quality of life (QOL) 3-4 months after diagnosis. Cox regression analyses were used to determine the predictors of survival time from the date of diagnosis to the date of death or the last follow-up. RESULTS After controlling for age, gender, and Breslow depth for the tumor, the baseline psychological variables related to the cancer-prone Type C response pattern, namely, anger nonexpression (repression), hopelessness, and better single-item self-reported QOL predicted shorter survival. Before hopelessness was added to the model, the amount of depressive symptoms and heavy perceived impact of diagnosis were also predictive. In addition, longer survival was strongly predicted by Cognitive Escape-Avoidance coping, which included items close to the concept of denial/minimizing. CONCLUSION Anger nonexpression, hopelessness, and overpositive reporting of QOL--all proposed to include in the Type C response style or reflect emotional nonexpression--seem to comprise a set of factors that reduce survival, whereas denial/minimizing response to the diagnosis as such predicts longer survival.
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Affiliation(s)
- Ulla-Sisko Lehto
- University of Tampere, Medical School, and Department of Oncology, Tampere University Hospital, Finland.
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Lehto US, Ojanen M, Dyba T, Aromaa A, Kellokumpu-Lehtinen P. Baseline psychosocial predictors of survival in localised breast cancer. Br J Cancer 2006; 94:1245-52. [PMID: 16670704 PMCID: PMC3216461 DOI: 10.1038/sj.bjc.6603091] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Revised: 03/13/2006] [Accepted: 03/13/2006] [Indexed: 11/08/2022] Open
Abstract
Despite the large number of studies on the impact of psychosocial factors on breast cancer progression, there is no certainty about the contributing factors or processes involved. We investigated the relative impacts of socioeconomic, psychological, and psychosocial factors on survival in breast cancer. A consecutive sample of 102 patients (participation 82%) under 72 years of age with locoregional breast cancer completed validated questionnaires on coping with cancer, emotional expression (anger), perceived available support, noncancer life stresses, and quality of life 3-4 months after diagnosis. Survival times were measured from the date of diagnosis to the date of relapse and further to the date of death or date of last follow-up. Cumulative Cox regression analyses were carried out. After controlling for biological prognostic factors, age, and baseline treatment, longer survival was predicted by a long education and a minimising-related coping, while shorter survival was predicted by emotional defensiveness (antiemotionality), behavioural-escape coping, and a high level of perceived support. A shorter event-free time was also predicted by unemployment and depressive symptoms. Cancer survival is affected by a complex combination of psychosocial factors, among which minimising predicts a favourable prognosis and anger nonexpression and escape behaviour an unfavourable prognosis. Higher socioeconomic status is associated with longer survival. High scores in well-being scales may reflect emotional nonexpression.
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Affiliation(s)
- U-S Lehto
- Department of Oncology, Medical School, University of Tampere, Helsinki, and Tampere University Hospital, Pikonlinna, Finland.
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Puig A, Lee SM, Goodwin L, Sherrard PA. The efficacy of creative arts therapies to enhance emotional expression, spirituality, and psychological well-being of newly diagnosed Stage I and Stage II breast cancer patients: A preliminary study. ARTS IN PSYCHOTHERAPY 2006. [DOI: 10.1016/j.aip.2006.02.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Trikas P, Vlachonikolis I, Askoxilakis I, Sanidas E, Tsiftsis D, Paritsis N. Low prebiopsy state irritability scores at the clinical onset of invasive breast carcinoma. J Psychosom Res 2004; 56:17-26. [PMID: 14987960 DOI: 10.1016/s0022-3999(03)00070-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2002] [Accepted: 01/07/2003] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The research findings regarding the role of psychiatric illness in breast cancer are not yet clear. This report investigates the differences between patients with invasive breast carcinoma (IBC) and patients with benign breast disease regarding the psychiatric history and the current prebiopsy psychopathology. METHODS The psychiatric history of 124 females, aged 70 or less, was evaluated by interview and the DSM-IV criteria were used to establish the diagnoses. The Present State Examination (PSE)-Index of Definition (ID)-CATEGO computer program was used to define current psychopathology. Known risk factors of breast cancer were included in the analyses. RESULTS After biopsy, 59 patients had IBC and 65 had benign breast diseases. Multiple logistic regression analyses showed that low psychiatric history and low irritability were independent predictors of IBC regarding the DSM-IV and the PSE-ID-CATEGO, respectively. CONCLUSION Low psychiatric history and low prebiopsy state irritability differentiates IBC patients from noncancer patients.
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Affiliation(s)
- Panayotis Trikas
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University Hospital of Heraklion, PO Box 1352, Heraklion 71 201, Crete, Greece.
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Allison PJ, Guichard C, Fung K, Gilain L. Dispositional optimism predicts survival status 1 year after diagnosis in head and neck cancer patients. J Clin Oncol 2003; 21:543-8. [PMID: 12560447 DOI: 10.1200/jco.2003.10.092] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the hypothesis that, independent of other known prognostic factors, pessimistic head and neck (H&N) cancer patients have a greater risk of being dead 1 year after diagnosis than do optimistic patients. PATIENTS AND METHODS A prospective observational study design was used with a cohort of H&N cancer patients diagnosed during the period from March 1, 1997, to August 31, 1998, at the Centre Hospitalier Universitaire, Clermont-Ferrand, France. Dispositional optimism (DO) was evaluated at baseline using a French version of the Life Orientation Test translated and validated for this study. One-year survival status was collected on all subjects. The analysis of the hypothesized association between DO and 1-year survival was performed using multiple logistic regression analysis, controlling for other sociodemographic and clinical variables. RESULTS The sample size was 101 patients, representing all but one of those patients fitting the inclusion criteria who were diagnosed during the recruitment period. Of these, 51 were alive at 1 year after diagnosis, 45 were dead, and five were lost to follow-up. The multivariate analysis was performed on the data from the 96 subjects in whom 1-year survival status was known. Controlling for known predictors of H&N cancer survival, pessimistic subjects (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01 to 1.24) and those living alone (OR, 4.14; 95% CI, 1.21 to 14.17) were more likely than optimistic subjects and those living with others to be dead at 1 year. CONCLUSION The results of this study of a cohort of French H&N cancer patients indicate that dispositional optimism predicts 1-year survival independent of other sociodemographic and clinical variables.
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Affiliation(s)
- Paul J Allison
- Faculty of Dentistry, McGill University, Montreal, Canada. paul.allison @mcgill.ca
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Dalton SO, Boesen EH, Ross L, Schapiro IR, Johansen C. Mind and cancer. do psychological factors cause cancer? Eur J Cancer 2002; 38:1313-23. [PMID: 12091060 DOI: 10.1016/s0959-8049(02)00099-0] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We have reviewed the evidence for an association between major life events, depression and personality factors and the risk for cancer. We identified and included only those prospective or retrospective studies in which the psychological variable was collected independently of the outcome. The evidence failed to support the hypothesis that major life events are a risk factor for cancer. The evidence was inconsistent for both depression and personality factors. Chance, bias or confounding may explain this result, as many of the studies had methodological weaknesses. The generally weak associations found, the inconsistency of the results, the unresolved underlying biological mechanism and equivocal findings of dose-response relationships prevent a conclusion that psychological factors are established risk factors. However, certain intriguing findings warrant further studies, which must, however, be well conducted and large and include detailed information on confounders.
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Affiliation(s)
- S O Dalton
- Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, The Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
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25
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Depressive symptomatology in relation to emotional control and chronic pain in persons who are HIV positive. Rehabil Psychol 2002. [DOI: 10.1037/0090-5550.47.4.402] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Irie M, Asami S, Nagata S, Ikeda M, Miyata M, Kasai H. Psychosocial factors as a potential trigger of oxidative DNA damage in human leukocytes. Jpn J Cancer Res 2001; 92:367-76. [PMID: 11267949 PMCID: PMC5926712 DOI: 10.1111/j.1349-7006.2001.tb01104.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Although numerous studies have been carried out on the stress-cancer linkage, the results are still inconclusive. One of the useful, but rarely applied, methods to assess this linkage is to examine the relationship between psychosocial stress and cancer-predisposing genetic alterations simultaneously. We investigated whether various psychosocial factors can be associated with the levels of 8-hydroxydeoxyguanosine (8-OH-dG), a biomarker of cancer-related oxidative DNA damage, in peripheral blood leukocytes in 362 healthy workers (276 males and 86 females). After adjustments for age, body mass index, cigarette smoking, and alcohol use, female subjects showed positive relationships between the amount of 8-OH-dG and the Tension-Anxiety, Depression-Rejection, Anger-Hostility, Fatigue, and Confusion scores of the Profile of Mood States, respectively. The levels of 8-OH-dG also increased reliably in the female subjects who had poor stress-coping behaviors, particularly wishful thinking strategy, in the NIOSH general job stress instrument. There were positive relationships of the 8-OH-dG levels to average working hours, a self-blame coping strategy, and recent loss of a close family member in male subjects. These findings in a nonclinical sample of healthy adults not only provide evidence of a stress-cancer linkage, but also suggest possible sex differences in the mechanisms of stress-related cancer initiation.
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Affiliation(s)
- M Irie
- Department of Mental Health, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
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Price MA, Tennant CC, Butow PN, Smith RC, Kennedy SJ, Kossoff MB, Dunn SM. The role of psychosocial factors in the development of breast carcinoma: Part II. Cancer 2001. [PMID: 11241235 DOI: 10.1002/1097-0142(20010215)91:4<686::aid-cncr1052>3.0.co;2-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Janne P, Tordeurs D, Michaux G, Ghislain MC, Mazy S, De Wispelaere JF, Libert Y, Reynaert C. [Breast cancer and its psychological approach: family, others, chance and...me]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2001; 29:28-33. [PMID: 11217190 DOI: 10.1016/s1297-9589(00)00053-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Since several years already, the scientific literature evoked the psycho-oncological perspective in the psychotherapeutic treatment of the patient suffering of a malignant mammary pathology. The objective of this article is to insist on some characteristics of personality inherent to the individual that suffers of a malignant mammary pathology. Comparing three groups of women (malignant mammary pathology--n = 51, benign mammary pathology--n = 71 and a group controls--n = 30), a set of questionnaires relating to locus of control and to the close circle--family and couple--has been managed. Results indicate that the woman suffering of a breast cancer is less "intern", consider that her health depends on factor "luck" and wish less cohesion and therefore more of distance within her couple and her family.
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Affiliation(s)
- P Janne
- Faculté de psychologie et des sciences de l'éducation, université catholique de Louvain, Belgique.
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Butow PN, Hiller JE, Price MA, Thackway SV, Kricker A, Tennant CC. Epidemiological evidence for a relationship between life events, coping style, and personality factors in the development of breast cancer. J Psychosom Res 2000; 49:169-81. [PMID: 11110988 DOI: 10.1016/s0022-3999(00)00156-2] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Review empirical evidence for a relationship between psychosocial factors and breast cancer development. METHODS Standardised quality assessment criteria were utilised to assess the evidence of psychosocial predictors of breast cancer development in the following domains: (a) stressful life events, (b) coping style, (c) social support, and (d) emotional and personality factors. RESULTS Few well-designed studies report any association between life events and breast cancer, the exception being two small studies using the Life Events and Difficulties Schedule (LEDS) reporting an association between severely threatening events and breast cancer risk. Seven studies show anger repression or alexithymia are predictors, the strongest evidence suggesting younger women are at increased risk. There is no evidence that social support, chronic anxiety, or depression affects breast cancer development. With the exception of rationality/anti-emotionality, personality factors do not predict breast cancer risk. CONCLUSION The evidence for a relationship between psychosocial factors and breast cancer is weak. The strongest predictors are emotional repression and severe life events. Future research would benefit from theoretical grounding and greater methodological rigour. Recommendations are given.
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Affiliation(s)
- P N Butow
- Department of Psychological Medicine, Royal North Shore Hospital, and University of Sydney, NWS 2065, Australia.
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Abstract
OBJECTIVE The aim of this paper was to review the evidence regarding the possibility of a relationship between psychological intervention and survival time of cancer patients. METHOD A literature search was conducted using CD ROM databases to identify studies which have evaluated the effects of psychological interventions on the survival time of cancer patients. The identified studies were critically reviewed. RESULTS Eight studies which used scientifically acceptable methodology to examine this question were identified. Three of these studies found evidence for a relationship between psychological intervention and patients' survival time, while five did not. Methodological issues and potentially confounding factors are discussed. CONCLUSION To date, a direct relationship between psychological intervention and patient survival time has not been conclusively demonstrated. Large-scale replication studies which are currently under way will provide more conclusive evidence on this question within the next few years.
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Affiliation(s)
- S Edelman
- Health Psychology Unit, University of Technology, Westbourne Street, Gore Hill, NSW, 2065, Sydney, Australia.
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Abstract
There is substantial evidence that health status and health outcomes are related to the availability and quality of personal relationships. The proposition that attachment relationships in childhood and adolescence have health-related implications fits within this research tradition, and has guided recent attempts to develop models linking attachment style with emotional regulation, coping mechanisms, and illness behaviours. The present paper discusses these theoretical models, together with relevant empirical findings. It is argued that measures of attachment security are related to symptom-reporting, health-care utilization, and restriction of normal activities, and that these links can be explained, in part, by individual differences in emotional and behavioural responses to stress. It is further noted that researchers have proposed physiological and biochemical pathways which may explain some of the effects of attachment style on physical health. The quality of parent-child attachment also predicts family responses to children's illness, as reflected in parents' visitation rates and in family participation in studies of health and illness. The implications of the findings for research and for practice in the health professions are briefly discussed.
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Affiliation(s)
- J A Feeney
- School of Psychology, University of Queensland, Queensland, Australia.
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Davison KP, Pennebaker JW, Dickerson SS. Who talks? The social psychology of illness support groups. AMERICAN PSYCHOLOGIST 2000. [DOI: 10.1037/0003-066x.55.2.205] [Citation(s) in RCA: 401] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
It is by now widely recognized that acute and chronic stress have an impact on the immune system. Acute stress may have a stimulating effect on the immune system, while in the case of chronic stress--and in particular in depression--the immune system may be down-regulated. However, there is considerable individual variability in the immune response to stress. This seems to a large extent to be determined by the subject's way of dealing with stress. The perception and evaluation of a stressor and the specific ways of stress coping may in different ways be related to various aspects of the stress response: sympathetic nervous system (SNS) activation and activation of the hypothalamic-pituitary-adrenal (HPA) axis, both systems affecting the immune system. Prolonged exposure to stressors or to severe life stresses may outweigh the person's coping resources leading to feelings of depression. The affective changes with the accompanying changes in the HPA axis are one of the hypothesized mechanisms underlying the immune changes in depression. It should be noted that the relationship between depression and immunity is affected by several other factors, such as gender and age and other personal resources. Increasing the subject's abilities to cope with stress and to reduce the negative affect by psychological interventions may on the other hand have a beneficial effect on the immune system.
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Affiliation(s)
- M Olff
- Department of Clinical Psychology, University of Groningen, Academic Hospital, The Netherlands.
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Boer MFD, Borne BVD, Pruyn JFA, Ryckman RM, Volovics L, Knegt PP, Meeuwis CA, Mesters I, Verwoerd CDA. Psychosocial and physical correlates of survival and recurrence in patients with head and neck carcinoma. Cancer 1998. [DOI: 10.1002/(sici)1097-0142(19981215)83:12<2567::aid-cncr24>3.0.co;2-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Waltz M, Kriegel W, van't Pad Bosch P. The social environment and health in rheumatoid arthritis: marital quality predicts individual variability in pain severity. ARTHRITIS CARE AND RESEARCH : THE OFFICIAL JOURNAL OF THE ARTHRITIS HEALTH PROFESSIONS ASSOCIATION 1998; 11:356-74. [PMID: 9830880 DOI: 10.1002/art.1790110507] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To examine prospective relations between a wide array of measures of social functioning and pain, while controlling for disease duration and activity and functional grade. METHODS As part of a larger study on health care utilization, longitudinal data were collected from 136 Dutch and 98 German outpatients on clinical status and pain. Social data included information on sexual handicap, spouse behavior, loneliness, daily emotional support, and the maintenance of pleasurable life domains. Pain severity was assessed at baseline and 12 months later with standard measures of pain and analyzed with hierarchical regressions. RESULTS Social measures obtained at baseline were consistently associated with pain at followup. Depression was a moderate correlate of pain in the Dutch and German samples. The regressions revealed that patient reports of negative spouse behavior (such as avoidance and critical remarks) and baseline depression predicted worse pain outcome, and this association remained significant in analyses controlling for baseline pain. The level of formal education was a weak correlate of disability, emotional support, and pain. Daily emotional support and social life domains associated with positive affect had an indirect influence on outcome. The absence of strong rather than weak social ties was the component of the loneliness construct linked to pain. These associations between social prognostic factors and pain severity, however, were mediated by psychological functioning at baseline. CONCLUSION The social environment was found to operate on the core health outcome, pain severity, via several pathways. Social functioning may be affected by rheumatoid arthritis (RA) progression, but it also appears to form a determinant of future health outcome. Not only the status of being married but also the quality of the relationship in terms of long-term stress and emotional support may be useful prognostic factors in RA.
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Affiliation(s)
- M Waltz
- Rheumatology Department, St. Willibrord Hospital, Emmerich, Germany
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Kirk KM, Martin NG. The Short Interpersonal Reactions Inventory, Self-regulation and differentiation scales in an older Australian twin sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 1998. [DOI: 10.1016/s0191-8869(98)00116-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Alfonso CA, Cohen MA. The role of group therapy in the care of persons with AIDS. THE JOURNAL OF THE AMERICAN ACADEMY OF PSYCHOANALYSIS 1998; 25:623-38. [PMID: 9592366 DOI: 10.1521/jaap.1.1997.25.4.623] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Assessing emotional expression: Spanish adaptation of the Rationality/Emotional Defensiveness Scale. PERSONALITY AND INDIVIDUAL DIFFERENCES 1997. [DOI: 10.1016/s0191-8869(96)00250-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
This study examined premorbid personality correlates of colon cancer and stage of presentation of colon cancer to health care providers. Sixty-one male veterans who completed the MMPI between 1947 and 1975 and were then diagnosed with colon cancer between 1977 and 1988 were matched with control patients. A 21-factor solution of the MMPI [1] was used to seek potential personality differences between colon cancer cases and their controls in terms of presence of colon cancer and stage of presentation for this disease. A stepwise conditional regression analysis found significant differences between the colon cancer and control groups on the Aggressive Hostility variable (p < 0.018). A multivariate analysis of variance conducted across the stages of colon cancer presentation found that patients who presented later on for colon cancer had higher Phobia scores (p < 0.05). Religious Fundamentalism was also related to presentation (p < 0.05), but in a nonlinear manner. Discussion is related to previous findings regarding the relationship between personality and development of cancer, as well as to implications for patient screening.
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Affiliation(s)
- M G Kavan
- Department of Family Practice, Creighton University School of Medicine, Omaha, Nebraska, 68124, USA
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Scheier MF, Bridges MW. Person variables and health: personality predispositions and acute psychological states as shared determinants for disease. Psychosom Med 1995; 57:255-68. [PMID: 7652126 DOI: 10.1097/00006842-199505000-00007] [Citation(s) in RCA: 137] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This article reviews prospective evidence linking certain classes of person variables to multiple disease end points. Included in the review is a consideration of the effects of hostility and anger, emotional suppression, depression, fatalism, and pessimism on coronary heart disease, cancer, and acquired immunodeficiency syndrome. A model is presented that integrates several of these variables into an overall conceptual scheme. In addition, several variables are identified that appear to moderate the strength of the relationships that are found between person variables and health. The article concludes with some suggested directions for future research.
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Affiliation(s)
- M F Scheier
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15215
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Miller D, Nott KH, Vedhara K. HIV and Psychoimmunology: Evidence Promising and Forthcoming. Med Chir Trans 1994; 87:687-90. [PMID: 7837193 PMCID: PMC1294938 DOI: 10.1177/014107689408701118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- D Miller
- Department of Public Health, Medicine and Epidemiology, University Hospital, Queen's Medical Centre, Nottingham, UK
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Graves PL, Mead LA, Wang NY, Liang KY, Klag MJ. Temperament as a potential predictor of mortality: evidence from a 41-year prospective study. J Behav Med 1994; 17:111-26. [PMID: 8035447 DOI: 10.1007/bf01858100] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Psychological factors were hypothesized to influence mortality, in particular, early versus later mortality. To explore the relationship between temperament, a psychological factor, and mortality in a prospective study of 1337 medical students, we constructed a measure portraying three temperament types, using latent class analysis. Death occurred in 113 subjects over 25-41 years of follow-up. In univariate survival analysis, subjects tending to direct tension "inward" when under stress ("Tension-In") had a higher risk of mortality than "Tension-Out" or "Stable" types. These associations persisted after adjustment for age, smoking, cholesterol level, and Quetelet Index. The relative risk (RR) of mortality for Tension-In was 1.56 (95% confidence interval, 1.00-2.44) compared with the Stable group. The risk was due entirely to the excess risk in persons under 55 years of age (RR, 2.59; 95% confidence interval, 1.46-4.62); the corresponding risk of death in older persons was 0.66 (0.30-1.48). Thus temperament is a significant risk factor for mortality, in particular, premature death.
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Affiliation(s)
- P L Graves
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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Abstract
This study deals with the association between life events, family history of mammary carcinoma and breast cancer. It was guided by a model consisting of events, family disposition and age at the side of the independent variables. In addition to these factors 'lack of social support' was introduced. The latter is conceptualized as a vulnerability factor capable of aggravating the impact of events without having an independent effect. There was no hypothesis on chronic difficulties, so this is exploratory. This research was conducted as a so-called 'limited prospective' design. Women with a suspicious breast lump were interviewed before surgery. After having confirmed the outcome of the surgery the sample was divided into a group with cancer and cases with a benign diagnosis. Women with gall stones were introduced as another control group. The interviews were performed along a semi-structured schedule, tape recorded and analyzed by using Brown and Harris' Life Events and Difficulties Scale. The analyses were made with 33 women with cancer, 59 with a benign tumor and 20 with gall stones. In the 'malignant' group the severest events was four times as high as in controls. All other degrees of threat were equally distributed over the groups. Chronic difficulties of the highest degree of severity also occur more often in the cancer group. They are not independent from events so that analyzing them separately is not useful. The rate of family history of breast cancer does not differ between the tumor groups, but is much lower in the gall stone patients. In the cancer group there is an association between this possibly hereditary factor and severe events, in the 'benign' group both are uncorrelated. The life event effect is explained in context of a higher illness susceptibility due to a hereditary disposition. For events occurring without it an explanation remains unclear.
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Affiliation(s)
- S Geyer
- Institut für Medizinische Soziologie, Heinrich-Heine-Universität Düsseldorf, Germany
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Ben-Shlomo Y, Smith GD, Shipley M, Marmot MG. Magnitude and causes of mortality differences between married and unmarried men. J Epidemiol Community Health 1993; 47:200-5. [PMID: 8350032 PMCID: PMC1059766 DOI: 10.1136/jech.47.3.200] [Citation(s) in RCA: 154] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
STUDY OBJECTIVE To determine the effect of marital status on mortality for men. In particular, to examine whether subgroups of unmarried men (widowed, single, and divorced/separated men) have a similar mortality to married men. DESIGN Cohort study. SETTING Whitehall civil service, London, between 1967 and 1969. PARTICIPANTS A total of 18,403 men aged 40-64 years with 18 years' follow up. MEASUREMENTS AND MAIN RESULTS Cause-specific mortality rates and risk factors at baseline were determined. Overall mortality was greater for all groups of unmarried men. Patterns of mortality were different in the subgroups of unmarried men. Widowed men had a significantly greater risk of dying from ischaemic heart disease (relative risk (RR) 1.46, 95% confidence interval (CI) 1.08, 1.97) which persisted after exclusion of deaths that occurred in the first two years. Divorced men had greater cancer mortality (RR 1.49; 95% CI 1.06, 2.10) that could not be explained simply by their greater consumption of cigarettes. The initial increased mortality for single men was no longer evident after adjustment for other risk factors, suggesting that single status in itself may not increase the risk. The risk for single men may have been underestimated, however, by over adjustment for possible intermediary factors. CONCLUSIONS Previous studies, which have examined total mortality only or have grouped all unmarried men, have masked interesting differences in the cause of death between subgroups of unmarried men. The extent to which the findings are explicable by psychosocial factors or the role of other environmental factors, which may also differ in relation to marital status, is unclear. Future work should not assume that all unmarried men have similar mortality risks and must examine the life course of each subgroup to advance our understanding of the possible causal role of marital status in disease aetiology.
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Affiliation(s)
- Y Ben-Shlomo
- Department of Epidemiology and Public Health, University College and Middlesex School of Medicine, University College, London
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Abstract
Relationships between the psychological characteristics absorption and neuroticism, and in vitro and in vivo measures of cell-mediated immunity were examined. Thirty-nine female subjects responded to questionnaires, donated blood for analysis of T-cell numbers, and were tested for delayed hypersensitivity skin responses. Consistent with the experimental hypothesis, subjects classified as repressors of negative affect (low absorption/low neuroticism), or extreme expressors of negative affect (high absorption/high neuroticism), showed lower immune responses than other groups of subjects. For the in vitro T-cell measures and the in vivo skin induration measures, there were also pervasive main effects of neuroticism, with subjects higher in neuroticism showing higher immunity than subjects lower in neuroticism.
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Affiliation(s)
- J D Shea
- Psychology Department, University of Newcastle, NSW Australia
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Dixon JP, Hickey M, Dixon JK. A causal model of the way emotions intervene between creative intelligence and conventional skills. NEW IDEAS IN PSYCHOLOGY 1992. [DOI: 10.1016/0732-118x(92)90034-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Hypnosis has been used successfully in treating cancer patients at all stages of disease and for degrees of pain. The experience of pain is influenced not only by physiological factors stemming from disease progression and oncological treatment, but also from psychosocial factors including social support and mood. Each of these influences must be considered in the successful treatment of pain. The successful use of hypnosis also depends upon the hypnotizability of patients, their particular cognitive style, their specific motivation, and level of cognitive functioning. While most patients can benefit from the use of hypnosis, less hypnotizable patients or patients with low cognitive functioning need to receive special consideration. The exercises described in this chapter can be successfully used in groups, individual sessions, and for hospice patients confined to bed. Both self-hypnosis and therapist guided hypnosis exercises are offered.
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