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Ernst M, Schwinn T, Hirschmiller J, Cleare S, Robb KA, Brähler E, Zwerenz R, Wiltink J, O'Connor RC, Beutel ME. To what extent are psychological variables considered in the study of risk and protective factors for suicidal thoughts and behaviours in individuals with cancer? A systematic review of 70 years of research. Clin Psychol Rev 2024; 109:102413. [PMID: 38518584 DOI: 10.1016/j.cpr.2024.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Psychological variables substantially shape the risk of suicidal thoughts and behaviours (STBs). However, it is unclear to what extent they are considered in individuals with cancer. We synthesized the quantitative research landscape concerning psychological risk/protective factors of STBs in the (psycho-) oncological context. This pre-registered review (PROSPERO-ID CRD42022331484) systematically searched the databases PubMed/Medline, CINAHL, PsycInfo, Cochrane Library, and Web of Science (as well as the grey literature and preprints). Risk of bias (RoB) was estimated using the ROBINS-I tool. Of 11,159 retrieved records, 319 studies were eligible for inclusion. Of those, 163 (51.1%) had investigated psychological factors (affective: n = 155; social: n = 65; cognitive: n = 63; personality/individual differences: n = 37; life events: n = 6), in a combined 3,561,741 participants. The most common STBs were suicidal ideation (n = 107) or death wishes (n = 20) rather than behaviour (suicide deaths: n = 26; attempts: n = 14). Most studies had a serious RoB. Thus, a large body of research investigated STBs in cancer patients/survivors, but it rarely aligned with the theoretical or clinical developments in suicide research. We propose a conceptual model of STBs in cancer delineating moderation and mediation effects to advance the integration of the fields, and to inform future research and practice.
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Affiliation(s)
- Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria; Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Kathryn A Robb
- Cancer Behaviour Research Group, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Leipzig, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Smith R, Persich MR, Chuning AE, Cloonan S, Woods-Lubert R, Skalamera J, Berryhill SM, Weihs KL, Lane RD, Allen JJB, Dailey NS, Alkozei A, Vanuk JR, Killgore WDS. Improvements in mindfulness, interoceptive and emotional awareness, emotion regulation, and interpersonal emotion management following completion of an online emotional skills training program. Emotion 2024; 24:431-450. [PMID: 37535567 PMCID: PMC10837318 DOI: 10.1037/emo0001237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Socioemotional skills, such as the ability to recognize, understand, and regulate the emotions of self and others, are associated with both physical and emotional health. The present study tested the effectiveness of a recently validated online training program for increasing these emotional skills in adults. In this study, 448 participants (323 female) were randomly assigned to complete this training program or a placebo control program. Among those who completed the training program or placebo (N = 326), the training program led to improved scores post-training on measures of interoceptive and emotional awareness, mindfulness, emotion recognition, and emotion regulation strategies (e.g., reduced emotion suppression and greater impulse control) relative to placebo. In a smaller group of participants who also completed a 6-month follow-up visit (N = 94), sustained improvements were observed on several measures in those who completed the training program, while the placebo group instead showed decreased performance. This suggested a potentially protective effect against emotional challenges associated with the COVID-19 pandemic occurring during this time. These results suggest that this online training program shows promise in improving emotional skills relevant to adaptive social and emotional functioning, and that it might be useful as an intervention within at-risk populations and those with emotional disorders associated with reduced application of these skills. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Ryan Smith
- University of Arizona
- Laureate Institute for Brain Research
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Reiss AB, Gulkarov S, Pinkhasov A, Sheehan KM, Srivastava A, De Leon J, Katz AE. Androgen Deprivation Therapy for Prostate Cancer: Focus on Cognitive Function and Mood. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:77. [PMID: 38256338 PMCID: PMC10819522 DOI: 10.3390/medicina60010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024]
Abstract
Prostate cancer is the second leading cause of cancer death in men in the United States. Androgen deprivation therapy (ADT) is currently the primary treatment for metastatic prostate cancer, and some studies have shown that the use of anti-androgen drugs is related to a reduction in cognitive function, mood changes, diminished quality of life, dementia, and possibly Alzheimer's disease. ADT has potential physiological effects such as a reduction in white matter integrity and a negative impact on hypothalamic functions due to the lowering of testosterone levels or the blockade of downstream androgen receptor signaling by first- and second-generation anti-androgen drugs. A comparative analysis of prostate cancer patients undergoing ADT and Alzheimer patients identified over 30 shared genes, illustrating common ground for the mechanistic underpinning of the symptomatology. The purpose of this review was to investigate the effects of ADT on cognitive function, mood, and quality of life, as well as to analyze the relationship between ADT and Alzheimer's disease. The evaluation of prostate cancer patient cognitive ability via neurocognitive testing is described. Future studies should further explore the connection among cognitive deficits, mood disturbances, and the physiological changes that occur when hormonal balance is altered.
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Affiliation(s)
- Allison B. Reiss
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (S.G.); (K.M.S.); (A.S.); (J.D.L.)
| | - Shelly Gulkarov
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (S.G.); (K.M.S.); (A.S.); (J.D.L.)
| | - Aaron Pinkhasov
- Department of Psychiatry, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA;
| | - Katie M. Sheehan
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (S.G.); (K.M.S.); (A.S.); (J.D.L.)
| | - Ankita Srivastava
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (S.G.); (K.M.S.); (A.S.); (J.D.L.)
| | - Joshua De Leon
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (S.G.); (K.M.S.); (A.S.); (J.D.L.)
| | - Aaron E. Katz
- Department of Urology, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA;
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4
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Massoeurs L, Ilie G, Lawen T, MacDonald C, Bradley C, Vo JDCT, Rutledge RDH. Psychosocial and Functional Predictors of Mental Disorder among Prostate Cancer Survivors: Informing Survivorship Care Programs with Evidence-Based Knowledge. Curr Oncol 2021; 28:3918-3931. [PMID: 34677252 PMCID: PMC8534362 DOI: 10.3390/curroncol28050334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/12/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022] Open
Abstract
Recent research has revealed that prostate cancer (PCa) survivors are facing a silent epidemic of mental disorder. These findings are not surprising when the side effects of highly effective current treatment modalities are considered. Here, we assess the association between urinary function and quality of life indicators to mental disorder among survivors of PCa. This is a cross sectional examination of an analytical sample of 362 men with a history of PCa residing in the Maritimes who took a survey assessing social, physical and health-related quality of life indicators between 2017 and 2021. Mental disorder was assessed using Kessler's Psychological Distress Scale (K-10). Predictor variables included emotional, functional, social/family and spiritual well-being, measured by Functional Assessment of Cancer Therapy-Prostate (FACT-P), and urinary function was measured by International Prostate Symptom Score (IPSS). Multivariate logistic regression analysis evaluated the contribution of predictors while controlling for age, income, survivorship time (months) since diagnosis, relationship status and treatment modality. Mental disorder was identified among 15.8% of PCa survivors in this sample. High emotional (aOR = 0.81, 95% CI: 0.69-0.96) and spiritual well-being (aOR = 0.88, 95% CI: 0.81-0.96) were protective factors against mental disorder. Men who screened positive for moderate to severe urinary tract symptoms had three times higher odds (aOR = 3.02, 95% CI: 1.10, 8.32) of screening positive for mental disorder. Men who were on active surveillance or radical prostatectomy with or without added treatment had higher (aOR = 5.87, 95% CI: 1.32-26.13 or aOR = 4.21, 95% CI: 1.07-16.51, respectively) odds of screening positive for mental disorder compared to men who received radiation treatment with or without hormonal therapy for their PCa diagnosis. Unmet emotional and spiritual needs, increased urinary problems and some forms of treatment (e.g., active surveillance or surgery) were associated with mental disorder among PCa survivors. The development of survivorship care programs and support systems that focus on the long-term effects of PCa treatments and the consequences of unmet psychosocial needs of patients during the survivorship journey are critically needed.
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Affiliation(s)
- Lia Massoeurs
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
| | - Gabriela Ilie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada;
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada;
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada;
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - Tarek Lawen
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Cody MacDonald
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
| | - Cassidy Bradley
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
| | - Jasmine Dang Cam-Tu Vo
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada;
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McMahon GC, Leapman MS. A disease by any other name: Effects of cancer grading nomenclature on perception of prostate cancer risk. Cancer 2021; 127:3290-3293. [PMID: 34081327 DOI: 10.1002/cncr.33619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/04/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Gregory C McMahon
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
| | - Michael S Leapman
- Department of Urology, Yale School of Medicine, New Haven, Connecticut.,Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, Connecticut
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Rice SM, Kealy D, Ogrodniczuk JS, Seidler ZE, Montaner G, Chambers S, Oliffe JL. The Anxiety Depression Pathway Among Men Following a Prostate Cancer Diagnosis: Cross-Sectional Interactions Between Anger Responses and Loneliness. Am J Mens Health 2021; 15:15579883211023699. [PMID: 34142615 PMCID: PMC8216379 DOI: 10.1177/15579883211023699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/17/2021] [Indexed: 11/15/2022] Open
Abstract
Anger has been a largely neglected emotion in prostate cancer research and intervention. This paper highlights the role of anger in the anxiety depression pathway among men with prostate cancer, and whether its impact is dependent on loneliness. Data are presented from a sample of men with prostate cancer (N = 105, M = 69.12 years, prostatectomy = 63.8%) and analysed using conditional process analysis. Dimensions of anger were evaluated as parallel mediators in bi-directional anxiety and depression pathways. Loneliness was evaluated as a conditional moderator of identified significant mediation relationships. Moderate severity depression (16.5%) was endorsed more frequently than moderate severity anxiety (8.6%, p = .008), with 19.1% of the sample reporting past two-week suicide ideation. Consistent with hypotheses, anger-related social interference (but not other dimensions of anger) significantly mediated the anxiety-depression pathway, but not the reverse depression-anxiety pathway. This indirect effect was conditional on men experiencing loneliness. Sensitivity analyses indicated the observed moderated mediation effect occurred for affective, but not somatic symptoms of depression. Findings support anger-related social interference (as opposed to anger frequency, intensity, duration or antagonism) as key to explaining the previously established anxiety-depression pathway. Results underscore the need for enhanced psychosocial supports for men with prostate cancer, with a particular focus on relational aspects. Supporting men with prostate cancer to adaptively process and manage their anger in ways that ameliorate negative social consequences will likely enhance their perceived social support quality, which may in turn better facilitate post-diagnosis recovery and emotional adjustment.
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Affiliation(s)
- Simon M. Rice
- Orygen, Parkville, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - John S. Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Zac E. Seidler
- Orygen, Parkville, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Gabriela Montaner
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
- Faculty of Health, University of Technology Sydney, Sydney NSW, Australia
| | - John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- Department of Nursing, The University of Melbourne, Australia
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Livingston JD, Youssef GJ, StGeorge J, Wynter K, Dowse E, Francis LM, Di Manno L, Teague S, Demmer D, Collins S, Wilford E, Leach L, Melvin GA, Macdonald JA. Paternal coping and psychopathology during the perinatal period: A mixed studies systematic review and meta-analysis. Clin Psychol Rev 2021; 86:102028. [PMID: 33975226 DOI: 10.1016/j.cpr.2021.102028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 03/10/2021] [Accepted: 03/30/2021] [Indexed: 12/25/2022]
Abstract
How fathers cope with stress may be critical to their mental health during the perinatal period. Using a sequential explanatory design for systematic review and meta-analysis, we aimed to identify associations and causal relations between higher- and lower-order avoidant and approach coping strategies and paternal psychopathology. We searched five electronic databases and grey literature, and used random-effects models to calculate pooled effects from 11 quantitative studies. Meta-analytic results were integrated with findings from 18 qualitative studies. Fathers' avoidant coping was positively associated with global psychopathology and depression. Approach-oriented coping, particularly problem-solving, was associated with positive affect but not psychopathology. Qualitative findings indicate distressed fathers employ avoidant coping strategies such as suppression, distraction, and social withdrawal. Approach-oriented coping strategies such as problem-solving and cognitive reappraisals appeared to be constructive components of men's coping repertoires supporting adaptation to fatherhood. Different coping strategies and approaches may reflect enactment of constrictive, moderate, or reinterpreted masculine norms. Study designs did not allow conclusions about causal relations between coping and psychopathology. Screening for, and targeting of, high avoidant coping among expectant and new fathers may help detect men at risk of or experiencing mental health difficulties and inform clinical response to psychopathology. Research examining whether different patterns of avoidant and approach coping are associated with psychopathology over time could inform interventions to support men's mental health and adaptation to fatherhood.
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Affiliation(s)
- Julianne D Livingston
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
| | | | - Karen Wynter
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia; Deakin University, Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Australia
| | - Eileen Dowse
- University of Newcastle, School of Nursing and Midwifery, Newcastle, Australia
| | - Lauren M Francis
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Laura Di Manno
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Samantha Teague
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - David Demmer
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Sam Collins
- Deakin University, Food & Mood Centre, IMPACT SRC, School of Medicine, Faculty of Health, Geelong, Australia
| | - Emily Wilford
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - Liana Leach
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - Glenn A Melvin
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Centre for Educational Development, Appraisal & Research, University of Warwick, Coventry, UK
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
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Male depression risk, psychological distress, and psychotherapy uptake: Validation of the German version of the male depression risk scale. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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