1
|
Onyedibe MCC. Social support moderates the relationship between emotion regulation and health-related quality of life in cancer patients. PSYCHOL HEALTH MED 2024; 29:1349-1361. [PMID: 38498978 DOI: 10.1080/13548506.2024.2325379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/26/2024] [Indexed: 03/20/2024]
Abstract
The relationship between emotion regulation (cognitive reappraisal and expressive suppression) and HRQoL in cancer patients is currently gaining momentum, yet, no research to date has investigated the nature of this relationship. The purpose of this study was to investigate the moderating role of social support in the relationship between ER and HRQoL in Nigerian cancer patients. Participants included 361 cancer patients (female = 56.79%, mean age = 41.61, SD 15.47) conveniently drawn from the oncology unit of the University Teaching Hospital, Nigeria. They completed the measures of Functional Assessment of Cancer Therapy-General (FACT-G), emotion regulation and Perceived Social Support. The moderated regression analysis via PROCESS procedures for SPSS Version 3 was used for data analysis. The results showed that cognitive reappraisal significantly predicted HRQoL (β = 2.12, t = 4.39, p = .000). Social support also significantly predicted HRQoL (β = .73, t = 4.57, p = .000). Most importantly, social support moderated the relationship between cognitive reappraisal and HRQoL (β = -.034, t= -4.23, p = .000), but not between expressive suppression and HRQoL (β = -.015, t= -1.61, p = .10). The moderation slope revealed that cognitive reappraisal significantly predicted HRQoL particularly at lower and moderate levels of social support. These findings reveal that the effect of emotion regulation on HRQoL depends much on an individual's level of perceived social support. It also means that social support boosted the positive impact of emotion regulation on HRQoL. The findings highlighted the importance of social-support and emotion regulation particularly, cognitive-reappraisal in improving health-related quality of life in cancer patients.
Collapse
|
2
|
Su CH, Liu Y, Hsu HT, Kao CC. Cancer Fear, Emotion Regulation, and Emotional Distress in Patients With Newly Diagnosed Lung Cancer. Cancer Nurs 2024; 47:56-63. [PMID: 35984922 DOI: 10.1097/ncc.0000000000001150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research related to newly diagnosed lung cancer patients' emotional regulation strategies and how these strategies influence their emotional distress is scarce. OBJECTIVE The aim of this study was to investigate the relationship between cancer fear, emotion regulation, and emotional distress in patients with newly diagnosed lung cancer. METHOD A cross-sectional, correlation research design was conducted, using self-report questionnaires: the Cancer Fear Scale, the Emotion Regulation Questionnaire, and the Hospital Anxiety and Depression Scale. A total of 117 newly diagnosed lung cancer patients were sampled. RESULTS Nearly 70% of newly diagnosed lung cancer patients had a high level of cancer fear; 56.4%, depression; and 45.3%, anxiety. Depression was positively associated with cancer fear ( r = 0.239, P < .01) and expressive suppression ( r = 0.185, P < .05), but negatively associated with cognitive reappraisal ( r = -0.323, P < .01). Anxiety was positively associated with cancer fear ( r = 0.488, P < .01) but negatively associated with cognitive reappraisal ( r = -0.214, P < .05). Cancer fear and cognitive reappraisal were significant explanatory factors and explained 25.2% of variance in anxiety. Cancer fear, expressive suppression, and cognitive reappraisal were significant explanatory factors and explained 16.7% of variance in depression. CONCLUSIONS Newly diagnosed lung cancer patients with cancer fear and who used fewer cognitive reappraisal strategies or more expressive suppression had more emotional distress. IMPLICATIONS FOR PRACTICE Clinicians should be attentive to patients' cancer fears and emotion regulation strategies as early as possible to prevent their emotional distress.
Collapse
Affiliation(s)
- Chia-Huei Su
- Author Affiliations: Department of Nursing (Ms Su and Dr Hsu) and Department of Medical Research (Dr Liu and Dr Hsu), Kaohsiung Medical University Hospital, Kaohsiung Medical University; College of Nursing (Dr Liu) and School of Nursing (Dr Hsu), Kaohsiung Medical University; and Department of Nursing, I-Shou University (Dr Kao), Kaohsiung, Taiwan, ROC
| | | | | | | |
Collapse
|
3
|
Sardessai-Nadkarni AA, Street RL. Understanding the pathways linking patient-centered communication to cancer survivors' emotional health: examining the mediating roles of self-efficacy and cognitive reappraisal. J Cancer Surviv 2023; 17:1266-1275. [PMID: 35167049 DOI: 10.1007/s11764-022-01170-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/10/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Many cancer survivors commonly face psychological health issues upon cancer diagnosis, both during and after treatment. Patient-centered communication can play an important role in improving health outcomes among cancer survivors across the cancer continuum. The current study examined the influence of patient-centered communication on self-efficacy in managing health, cognitive reappraisal, and emotional distress among cancer survivors. METHODS The analysis was conducted on a subsample of 809 cancer survivors acquired from a nationally representative 2019 Health Information National Trends Survey 5 (Cycle 3). Multivariate regression analysis was conducted to explore the pathways through which patient-centered communication can be associated with cancer survivors' emotional distress, mediated by self-efficacy and cognitive reappraisal. RESULTS The results indicated that effective patient-centered provider communication led to higher self-efficacy in managing health, greater involvement in cognitive reappraisal, and decreased emotional distress among cancer survivors. Additionally, the results revealed that the effect of patient-centered communication that led to decreased emotional distress was fully mediated through self-efficacy and cognitive reappraisal. CONCLUSIONS Although patient-centered communication positively relates to various emotional health outcomes among cancer survivors, it does not affect their emotional health directly. Self-efficacy and cognitive reappraisal play a crucial role in explaining the underlying mechanisms of such effects. IMPLICATIONS FOR CANCER SURVIVORS Future interventions to promote patient-centered communication in cancer care should give more emphasis to managing patients' emotions. Providers should not only recognize, elicit, and respond to patient's emotions, but also develop emotional regulation skills among patients, and improve their ability to cope with emotional distress.
Collapse
Affiliation(s)
| | - Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
4
|
Wang X, Tu Q, Huang D, Jin P, Cai X, Zhao H, Lu Z, Dong C. A latent profile analysis of emotional expression among patients with unintentional injuries. BMC Psychiatry 2022; 22:729. [PMID: 36424565 PMCID: PMC9694566 DOI: 10.1186/s12888-022-04390-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Emotional expression has been suggested to affect the well-being of individuals with unintentional injuries. However, few studies have investigated it as a heterogeneous phenomenon. The purpose of this study was to characterize the patterns of emotional expression among patients with unintentional injuries using latent profile analysis, and to examine the relationship among these latent profiles and cognitive processing, posttraumatic growth, and posttraumatic stress disorder. METHODS A cross-sectional study was carried out at two general hospitals in Wenzhou, China. In total, 352 patients with unintentional injuries completed the socio-demographic questionnaire, Berkeley Expressivity Questionnaire, Ambivalence Over Emotional Expression Questionnaire, Event-Related Rumination Inventory, the Posttraumatic Growth Inventory, and PTSD Checklist-Civilian Version. RESULTS: Three unique profiles were identified: high emotional expressivity (n = 238, 67.6%), moderate emotional expressivity (n = 45, 12.8%), and low emotional expressivity (n = 69, 19.6%). The ANOVA and chi-square tests demonstrated significant differences among the three groups concerning deliberate rumination and posttraumatic growth. Multinomial logistic regression analysis indicated that monthly income and time since injury significantly predicted profile membership. CONCLUSIONS Most patients showed high emotional expressivity after an unintentional injury. Emotional expression profiles were associated with deliberate rumination and posttraumatic growth. Emotional expression interventions tailored for different profiles are warranted after an unintentional injury.
Collapse
Affiliation(s)
- Xinlu Wang
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Qiongyao Tu
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Dongdong Huang
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Pinpin Jin
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Xue Cai
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Haifeng Zhao
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China ,grid.416271.70000 0004 0639 0580Ningbo City First Hospital, Ningbo, China
| | - Zhongqiu Lu
- Emergency Intensive Care Unit, Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
5
|
Durosini I, Triberti S, Savioni L, Sebri V, Pravettoni G. The Role of Emotion-Related Abilities in the Quality of Life of Breast Cancer Survivors: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912704. [PMID: 36232004 PMCID: PMC9566755 DOI: 10.3390/ijerph191912704] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 05/29/2023]
Abstract
Breast cancer survivors have to deal with notable challenges even after successful treatment, such as body image issues, depression and anxiety, the stress related to changes in lifestyle, and the continual challenges inherent to health management. The literature suggests that emotional abilities, such as emotional intelligence, emotion management, mood repair, and coping play a fundamental role in such challenges. We performed a systematic review to systematize the evidence available on the role of emotional abilities in quality of life and health management in breast cancer survivors. The search was performed on three scientific databases (Pubmed, Scopus, and PsycINFO) and, after applying exclusion criteria, yielded 33 studies, mainly of a cross-sectional nature. The results clearly support the hypothesis that emotional abilities play multiple important roles in breast cancer survivors' quality of life. Specifically, the review highlighted that coping/emotional management plays multiple roles in breast cancer survivors' well-being and health management, affecting vitality and general adjustment to cancer positivity and promoting benefit findings related to the cancer experience; however, rare negative results exist in the literature. This review highlights the relevance of emotional abilities to promoting quality of life in breast cancer survivors. Future review efforts may explore other breast cancer survivors' emotional abilities, aiming at assessing available instruments and proposing tailored psychological interventions.
Collapse
Affiliation(s)
- Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Stefano Triberti
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Lucrezia Savioni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Valeria Sebri
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| |
Collapse
|
6
|
Wang Y, Zheng Z, Wang X, Li Y. Unraveling the effect of ambivalence over emotional expression on subjective wellbeing in Chinese college students in romantic relationships: A multiple mediation model. Front Psychiatry 2022; 13:982406. [PMID: 36159942 PMCID: PMC9492933 DOI: 10.3389/fpsyt.2022.982406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/16/2022] [Indexed: 11/26/2022] Open
Abstract
The sudden and unpredictable outbreak of the COVID-19 pandemic has severely threatened young adults' physical and mental health and damaged the quality of relationships. As a critical stage of development, their well-being is more vulnerable to adverse environments which may lead to profound negative long-life mental health status. The current study aimed to investigate the mediation effects of fear of intimacy and attachment avoidance in the association between ambivalence over emotional expression and subjective wellbeing. A sample of 555 Chinese college students who are currently involved in romantic relationships (Mean age = 19.69, SD age = 1.36, 52% females) completed anonymous questionnaires regarding ambivalence over emotional expression, fear of intimacy, attachment avoidance, and subjective wellbeing. The findings revealed that ambivalence over emotional expression can predict negative subjective wellbeing of college students in romantic relationships significantly, and fear of intimacy and attachment avoidance played a sequentially mediating role in the association between ambivalence over emotional expression and subjective wellbeing. Surprisingly, when considering attachment avoidance independently, we found it had an inhibitory action on the link between ambivalence over emotional expression and subjective wellbeing. The present study contributes to a better understanding of how ambivalence over emotional expression can decrease subjective wellbeing, and also has implications for the intervention of students' subjective wellbeing and closeness during the period of COVID-19.
Collapse
Affiliation(s)
- Yue Wang
- School of Education, Zhengzhou University, Zhengzhou, China
| | - Zexin Zheng
- School of Education, Zhengzhou University, Zhengzhou, China
| | - Xiaoyu Wang
- School of Education, Zhengzhou University, Zhengzhou, China
| | - Ying Li
- School of Education, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
7
|
Li F, Ren L, Wang X, Jin Y, Yang Q, Wang D. A network perspective on marital satisfaction among older couples. JOURNAL OF PACIFIC RIM PSYCHOLOGY 2022. [DOI: 10.1177/18344909221117257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It will be helpful for older people to maintain good mental health by improving their marital satisfaction. The present study investigates how the elements of marital satisfaction among older couples are related to each other and reveal the key elements. Four hundred ninety-four older people participated in the study. Marital satisfaction was assessed by the 10-item marital satisfaction subscale of the ENRICH scale. Network analysis was adopted to estimate the network structure of these 10 items and the strength centrality of each item was calculated. The results showed that all edges in the final network were positive. Four edges with the strongest regularized partial correlations appeared between “ leisure activities and spending time together” and “ emotional expression”; “ personality and habits” and “ communication and understanding”; “ economic status and the manner of determining economic affairs” and “ relationship with relatives and friends”; and “ make decisions and resolve conflict” and “ emotional expression.” In addition, “ emotional expression” had the highest node strength value in the network. “ Communication and understanding” and “ views are consistent” had the second and third highest node strength values, respectively. “ Views are consistent” was more central in males than females and was the second central node in male networks. In conclusion, the present study offers a new perspective to deepen the understanding about the internal structure of marital satisfaction among older couples via network analysis. The results might provide potential targets of intervention for social workers or family therapists to greatly improve marital satisfaction among older couples.
Collapse
Affiliation(s)
- Fengzhan Li
- Department of Military Medical Psychology, Air Force Medical University, PLA, Xi’an, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, PLA, Xi’an, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, PLA, Xi’an, China
| | - Yinchuan Jin
- Department of Military Medical Psychology, Air Force Medical University, PLA, Xi’an, China
| | - Qun Yang
- Department of Military Medical Psychology, Air Force Medical University, PLA, Xi’an, China
| | - Dahua Wang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| |
Collapse
|
8
|
Moura R, Camilo C, Luís S. As Strong as We Are United: Effects of Intrapersonal and Interpersonal Emotion Regulation on Quality of Life in Women With Breast Cancer. Front Psychol 2021; 12:661496. [PMID: 34630197 PMCID: PMC8498330 DOI: 10.3389/fpsyg.2021.661496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/19/2021] [Indexed: 11/14/2022] Open
Abstract
Women diagnosed with breast cancer often experience unpleasant emotions, resulting in higher levels of emotional burden and decreased levels of wellbeing and quality of life. The present correlational and cross-sectional study aims to compare the implementation of two regulatory levels, intrapersonal and interpersonal (as social sharing of emotions), and two types of strategies, antecedent-focused and response-focused, and explore their impact on breast cancer patients’ perception of quality of life. Sixty-eight women previously diagnosed with the disease participated in this study, with a mean age of 63years old (SD=11.58). Data were collected through a self-report questionnaire to assess emotional experience, intrapersonal regulation, social sharing of emotions, and breast cancer-related wellbeing and quality of life. Data yielded that most of the participants regulated their negative emotions within social interactions and made more use of antecedent-focused strategies to cognitively reformulate the emotional episode. Social and family wellbeing were positively associated with antecedent-focused strategies, as well as intrapersonal and interpersonal regulatory levels. Moreover, the occurrence of sharing episodes and social interactions played an important and beneficial role on patients’ perceived quality of life. These findings reinforce the importance of promoting an adaptive intrapersonal regulation among breast cancer patients. Results also suggest that social sharing of emotions is an efficient process to help them to better cope with the psychological and emotional burden of the disease, thus positively influencing the way they perceive their social and family wellbeing, as well as their quality of life.
Collapse
Affiliation(s)
- Rita Moura
- CIS-IUL, Iscte - Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Cristina Camilo
- CIS-IUL, Iscte - Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Sílvia Luís
- Instituto Superior de Ciências Sociais e Políticas, Centro de Administração e de Políticas Públicas, Universidade de Lisboa, Lisbon, Portugal.,Escola de Psicologia e Ciências da Vida, HEI-Lab, Universidade Lusófona de Humanidades e Tecnologias de Lisboa, Lisbon, Portugal
| |
Collapse
|
9
|
Hu Y, Xu J, Wang X, Shi Y, Chen M, Im EO. Socio-Ecological Environmental Characteristics of Young Chinese Breast Cancer Survivors. Oncol Nurs Forum 2021; 48:481-490. [PMID: 34411083 DOI: 10.1188/21.onf.481-490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the environmental characteristics of young breast cancer survivors (YBCSs) in China. PARTICIPANTS & SETTING 17 participants aged 18-45 years were recruited from hospitals and through participant referral in Shanghai, China. METHODOLOGIC APPROACH Semistructured interviews were conducted to explore the environmental characteristics of YBCSs. Content analysis was performed to analyze the data. FINDINGS The following four domains emerged from the analysis. IMPLICATIONS FOR NURSING The study provides insights into the specific issues of YBCSs at different environmental levels. Nurses should collaborate with the healthcare team, family members, and other stakeholders in addressing these issues to support YBCSs. Culturally tailored support should be developed to release the burden of socially desired roles and other cultural issues for Chinese YBCSs.
Collapse
Affiliation(s)
- Yun Hu
- Shanghai Jiao Tong University
| | | | | | | | | | | |
Collapse
|
10
|
Zhao H, Li X, Zhou C, Wu Y, Li W, Chen L. Psychological distress among Chinese patients with breast cancer undergoing chemotherapy: Concordance between patient and family caregiver reports. J Adv Nurs 2021; 78:750-764. [PMID: 34363625 DOI: 10.1111/jan.15004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/01/2021] [Accepted: 07/24/2021] [Indexed: 02/06/2023]
Abstract
AIMS To examine patient-caregiver concordances about psychological distress among Chinese patients with breast cancer undergoing chemotherapy and identify factors related to concordance among patients and family caregivers. DESIGN Cross-sectional study. METHODS From October 2019 to June 2020, 137 patient-caregiver dyads were enrolled. Sociodemographic information, the distress thermometer (including the problem list), the Distress Disclosure Index and the Family Adaptability and Cohesion Evaluation Scale were used to collect data. Data were analysed using intraclass correlation coefficients (ICC), kappa statistics, two related samples test, chi-square tests and/or Fisher's exact tests and binary logistic regression. RESULTS Overall, fair agreement was identified between patients' and caregivers' reports (intraclass correlation coefficients [ICC] = .528). Patients reported significantly higher psychological distress scores than paired caregiver reports. Lower psychological distress concordance was found among patients with comorbidities (odds ratio [OR], 0.352; 95% confidence interval [CI], 0.155-0.798) and lower levels of self-disclosure (OR, 0.402; 95% CI, 0.186-0.868). CONCLUSION There was relatively low concordance between patients' reports and caregivers' perceptions of psychological distress. Family caregivers tended to underestimate patients' psychological distress. A comorbid condition and lower levels of self-disclosure contributed to this bias. IMPACT Having an awareness of the incongruence between patient and caregiver may help healthcare providers better interpret caregiver assessments. Healthcare providers should reinforce patient-caregiver dyadic psychosocial education to improve concordance. More psychological care and substantial emotional support should be provided for Chinese breast cancer patients undergoing chemotherapy by family caregivers and healthcare providers.
Collapse
Affiliation(s)
- Huihui Zhao
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Xiaojin Li
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Wenji Li
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Liling Chen
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| |
Collapse
|
11
|
Chu Q, Wong CCY, Chen L, Shin LJ, Chen L, Lu Q. Self-stigma and quality of life among Chinese American breast cancer survivors: A serial multiple mediation model. Psychooncology 2021; 30:392-399. [PMID: 33175446 PMCID: PMC10044476 DOI: 10.1002/pon.5590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/17/2020] [Accepted: 10/29/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Despite the increasing scholarly attention toward self-stigma among Asian breast cancer survivors, research is limited about the underlying psychological mechanisms by which self-stigma may influence quality of life for this population. The present study investigated how self-stigma is associated with quality of life among Chinese American breast cancer survivors by examining the serial mediating effects of concerns about breast cancer, self-efficacy for coping with cancer, and depressive symptoms. METHODS Chinese American breast cancer survivors (n = 112) completed a questionnaire packet assessing self-stigma related to breast cancer, concerns about breast cancer, self-efficacy for coping with cancer, depressive symptoms, and quality of life. Path analysis was conducted to test the hypothesized serial multiple mediation model. RESULTS The hypothesized model was supported: self-stigma was negatively associated with quality of life through concerns about breast cancer, self-efficacy, and depressive symptoms. After the mediators were controlled for, the direct effect of self-stigma on quality of life was no longer significant. CONCLUSIONS Our findings suggest that concerns about breast cancer, self-efficacy for coping, and depressive symptoms are important pathways through which self-stigma may influence quality of life among Chinese American breast cancer survivors. Healthcare practitioners should be aware of survivors' self-stigma and make efforts to alleviate survivors' excessive cancer concerns, facilitate their self-efficacy, and offer emotional support to improve quality of life for this population.
Collapse
Affiliation(s)
- Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Celia C Y Wong
- The College at Brockport, State University of New York, Brockport, New York, USA
| | - Lingjun Chen
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lilian J Shin
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Leqi Chen
- Department of Mathematics and Applied Mathematics, University of Science and Technology Beijing, Beijing, China
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Psychology, University of Houston, Houston, Texas, USA
| |
Collapse
|
12
|
Williamson TJ, Ostroff JS, Martin CM, Banerjee SC, Bylund CL, Hamann HA, Shen MJ. Evaluating relationships between lung cancer stigma, anxiety, and depressive symptoms and the absence of empathic opportunities presented during routine clinical consultations. PATIENT EDUCATION AND COUNSELING 2021; 104:322-328. [PMID: 32859447 PMCID: PMC7855769 DOI: 10.1016/j.pec.2020.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/26/2020] [Accepted: 08/03/2020] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Empathic communication in clinical consultations is mutually constructed, with patients first presenting empathic opportunities (statements communicating emotions, challenges, or progress) to which clinicians can respond. We hypothesized that lung cancer patients who did not present empathic opportunities during routine consultations would report higher stigma, anxiety, and depressive symptoms than patients who presented at least one. METHODS Audio-recorded consultations between lung cancer patients (N = 56) and clinicians were analyzed to identify empathic opportunities. Participants completed questionnaires measuring sociodemographic and psychosocial characteristics. RESULTS Twenty-one consultations (38 %) did not contain empathic opportunities. Unexpectedly, there was a significant interaction between presenting empathic opportunities and patients' race on disclosure-related stigma (i.e., discomfort discussing one's cancer; F = 4.49, p = .041) and anxiety (F = 8.03, p = .007). Among racial minority patients (self-identifying as Black/African-American, Asian/Pacific Islander, or other race), those who did not present empathic opportunities reported higher stigma than those who presented at least one (t=-5.47, p = .038), but this difference was not observed among white patients (t = 0.38, p = .789). Additional statistically significant findings emerged for anxiety. CONCLUSION Disclosure-related stigma and anxiety may explain why some patients present empathic opportunities whereas others do not. PRACTICE IMPLICATIONS Clinicians should intentionally elicit empathic opportunities and encourage open communication with patients (particularly from diverse racial backgrounds).
Collapse
Affiliation(s)
- Timothy J Williamson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chloé M Martin
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Carma L Bylund
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA; College of Medicine, University of Florida, Gainesville, FL, USA
| | - Heidi A Hamann
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | | |
Collapse
|
13
|
Emotion regulation in adolescents: Influences of internal representations of relationships - An ERP study. Int J Psychophysiol 2020; 160:1-9. [PMID: 33278467 DOI: 10.1016/j.ijpsycho.2020.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 01/10/2023]
Abstract
Emotion regulation (ER) strategies can decrease the intensity or modify the experience of emotions. Deficits in emotion regulation are implicated in a wide range of psychopathologies. It is argued that interpersonal, socio-cognitive, and developmental variables play an important role in ER. This is the first study to explore the contribution of individual differences in internal representations of relationships (IRR) to neural correlates of ER in a sample of adolescents. Event related potentials of 53 adolescents (12 to 17 years old) were collected while performing an ER task. IRR was assessed with the social cognition and object relations scale (SCORS-G; Westen, 1995) coding of narratives from interviews. Results show that individual differences in IRR significantly predicted the modulation of emotional responses by expressive suppression in adolescents, accounting for 48% of the variance of changes in occipital late positive potentials (LPP). Thus, it appears that IRR are implicated in an individual's ability to regulate emotions. The clinical implications of the findings are discussed.
Collapse
|
14
|
Chu Q, Wu IHC, Tang M, Tsoh J, Lu Q. Temporal relationship of posttraumatic stress disorder symptom clusters during and after an expressive writing intervention for Chinese American breast cancer survivors. J Psychosom Res 2020; 135:110142. [PMID: 32485623 DOI: 10.1016/j.jpsychores.2020.110142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is a significant condition and frequently observed among breast cancer survivors. Extant literature has demonstrated the effectiveness of expressive writing interventions in reducing PTSD among breast cancer survivors. However, little is known about how different PTSD symptom clusters influence each other over time during and after the expressive writing intervention among breast cancer survivors. We investigated how the three PTSD symptom clusters (reexperiencing, avoidance and hyperarousal) influence each other during and after an expressive writing intervention among Chinese American breast cancer survivors. METHODS Chinese American breast cancer survivors (n = 136) completed an expressive writing intervention. Their PTSD symptoms were assessed at baseline, 1-, 3-, and 6-month follow-ups. RESULTS Using cross-lagged panel analysis, the model with hyperarousal symptoms at each assessment wave predicting the subsequent severity of avoidance and reexperiencing symptoms indicated the best fit, χ2(52) = 65.422, p = .100; CFI = 0.990, RMSEA = 0.044, 95% CI [0.000, 0.074]. CONCLUSION The results suggest that hyperarousal symptoms predict the subsequent severity of reexperiencing and avoidance symptoms over time during and after the expressive writing intervention. The findings highlight the importance of early diagnosis, monitoring and treatment of hyperarousal symptoms in enhancing the efficacy of PTSD interventions and reducing the chronicity in PTSD among Chinese American breast cancer survivors. Clinical Trial Registration atClinicalTrials.gov: NCT02946619.
Collapse
Affiliation(s)
- Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ivan Haw Chong Wu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Moni Tang
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Janice Tsoh
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Psychology, University of Houston, Houston, TX, USA.
| |
Collapse
|
15
|
Antúnez JM. Circadian typology is related to emotion regulation, metacognitive beliefs and assertiveness in healthy adults. PLoS One 2020; 15:e0230169. [PMID: 32168366 PMCID: PMC7069650 DOI: 10.1371/journal.pone.0230169] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 02/21/2020] [Indexed: 01/10/2023] Open
Abstract
Circadian typology has been related to several mental health aspects such as resilience, perceived well-being, emotional intelligence and psychological symptoms and disorders. However, the relationship between circadian typology and emotion regulation, metacognitions and assertiveness, which constitute core constructs related to psychological well-being and psychopathology, remain unexplored. This study aims to analyze whether circadian typology is related with those three constructs, considering the possible influence of sex. 2283 participants (833 women), aged 18–60 years (30.37 ± 9.26 years), completed the reduced Morningness-Eveningness Questionnaire, the Emotion Regulation Questionnaire, the Meta-Cognitions Questionnaire 30, and the Rathus Assertiveness Schedule. Main effects were observed between circadian typology and cognitive reappraisal, metacognitions, negative beliefs of uncontrollability and danger, cognitive confidence, cognitive self-consciousness, and assertiveness (F(2,2276) > 4.80, p < 0.009, ηp2 > 0.004, in all cases). Morning-type participants scored lower than evening-type in general metacognitive beliefs, negative beliefs of uncontrollability and danger, cognitive confidence, and cognitive self-consciousness, and higher than evening-type in cognitive reappraisal and assertiveness, while neither-type exhibited intermediate scores (p < 0.033 in all cases). According to the results, evening-type individuals might display a higher tendency to support maladaptive beliefs about thinking itself as well as a lesser tendency to reappraise a potentially emotion eliciting situations in order to modify its meaning and its emotional impact and to exert their rights respectfully. This new evidence improves the understanding of the relationships between circadian typology and psychological factors related to psychological well-being and psychopathology. Results implications for the onset and maintenance of psychological problems are discussed. Although future longitudinal studies are needed, results emphasize evening-type as a risk factor for the development of psychological disturbances and morning-type as a protective factor against those.
Collapse
Affiliation(s)
- Juan Manuel Antúnez
- Department of Personality, Assessment and Psychological Treatment, University of Málaga, Málaga, Andalucía, Spain
- * E-mail:
| |
Collapse
|
16
|
Ji L, Tsai W, Sun X, Lu Q, Wang H, Wang L, Lu G. The detrimental effects of ambivalence over emotional expression on well‐being among Mainland Chinese breast cancer patients: Mediating role of perceived social support. Psychooncology 2019; 28:1142-1148. [DOI: 10.1002/pon.5069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Li‐li Ji
- Department of Medical NursingWeifang Medical University Weifang
| | - William Tsai
- Department of Applied PsychologyNew York University New York City New York
| | - Xiang‐lian Sun
- Department of Breast SurgeryWeifang People's Hospital Weifang
| | - Qian Lu
- Department of PsychologyUniversity of Houston Houston Texas
- Department of Health Disparities ResearchUniversity of Texas MD Anderson Cancer Center Houston Texas
| | - Hui‐dong Wang
- Department of Breast SurgeryWeifang People's Hospital Weifang
| | - Li‐juan Wang
- Department of Breast SurgeryWeifang People's Hospital Weifang
| | - Guo‐hua Lu
- Department of PsychologyWeifang Medical University Weifang
| |
Collapse
|
17
|
Tsai W, Wu IHC, Lu Q. Acculturation and quality of life among Chinese American breast cancer survivors: The mediating role of self-stigma, ambivalence over emotion expression, and intrusive thoughts. Psychooncology 2019; 28:1063-1070. [PMID: 30838727 DOI: 10.1002/pon.5053] [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: 09/17/2018] [Revised: 02/22/2019] [Accepted: 02/28/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Highly acculturated Chinese American breast cancer survivors have greater access to health care providers, are English language proficient, and have more knowledge about the health care system. However, less is known about the potential psychosocial factors that may account for the health benefits of acculturation. As such, the current study seeks to understand how mainstream acculturation is associated with higher quality of life by investigating self-stigma, ambivalence over emotion expression (AEE), and intrusive thoughts, as serial mediators among Chinese breast cancer survivors. METHODS One hundred twelve Chinese American breast cancer survivors completed a self-reported questionnaire with these trait variables. RESULTS We found support for a serial multiple mediation hypothesis in which mainstream acculturation was indirectly associated with quality of life through self-stigma, AEE, and intrusive thoughts. Specifically, mainstream acculturation was associated with lower self-stigma, which, in turn, was associated with lower AEE and intrusive thoughts and subsequently resulted in lower quality of life among Chinese American breast cancer survivors. CONCLUSIONS The findings suggest that psychosocial factors are important mechanisms through which acculturation is associated with quality of life among Chinese American breast cancer survivors. As Chinese immigrants acculturate to mainstream American culture, they may benefit from the reduced public stigma toward breast cancer and incorporate new post-immigration knowledge about cancer that protects them from high levels of self-stigma. This, in turn, may lead Chinese American breast cancer survivors to experience lower AEE and intrusive thoughts and subsequently experience higher quality of life.
Collapse
Affiliation(s)
- William Tsai
- Department of Applied Psychology, New York University, New York, New York
| | - Ivan H C Wu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
18
|
Tsai W, Lu Q. Ambivalence over emotional expression and intrusive thoughts as moderators of the link between self-stigma and depressive symptoms among Chinese American breast cancer survivors. J Behav Med 2018; 42:452-460. [PMID: 30474805 DOI: 10.1007/s10865-018-9996-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Abstract
Due to successful public health campaigns, breast cancer has successfully transformed from a highly stigmatized illness to a philanthropically supported disease in the United States. However, Chinese American breast cancer survivors continue to experience high levels of self-stigma and associated negative mental health outcomes. In the present study, we examined the relations between self-stigma and depressive symptoms, and further tested individual difference variables such as ambivalence over emotional expression and intrusive thoughts that may exacerbate the harmful effects of self-stigma among this population. One hundred and twelve foreign-born Chinese breast cancer survivors living in the United States completed questionnaires measuring self-stigma, depressive symptoms, AEE, and intrusive thoughts. We found significant AEE × self-stigma and intrusive-thought × self-stigma interaction effects in predicting depressive symptoms. Specifically, the relationships between self-stigma and depressive symptoms were exacerbated among individuals with high levels of AEE and intrusive thoughts. Self-stigma represents a significant predictor of depressive symptoms among Chinese breast cancer survivors, and particularly so for individuals with higher levels of AEE and intrusive thoughts. The findings suggest that for interventions designed to reduce the negative mental health outcomes associated with self-stigma, targeting risk factors such as AEE and intrusive thoughts might be promising.
Collapse
Affiliation(s)
- William Tsai
- Department of Applied Psychology, New York University, New York, USA.
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, USA. .,Department of Psychology, University of Houston, Houston, USA.
| |
Collapse
|