Loneliness, social support and cardiovascular reactivity to laboratory stress

Self-reported or explicit loneliness and social support have been inconsistently associated with cardiovascular reactivity (CVR) to stress. The present study aimed to adapt an implicit measure of loneliness, and use it alongside the measures of explicit loneliness and social support, to investigate their correlations with CVR to laboratory stress. Twenty-five female volunteers aged between 18 and 39 years completed self-reported measures of loneliness and social support, and an Implicit Association Test (IAT) of loneliness. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) reactivity indices were measured in response to psychosocial stress induced in the laboratory. Functional support indices of social support were significantly correlated with CVR reactivity to stress. Interestingly, implicit, but not explicit, loneliness was significantly correlated with DBP reactivity after one of the stressors. No associations were found between structural support and CVR indices. Results are discussed in terms of validity of implicit versus explicit measures and possible factors that affect physiological outcomes

Social Support, Loneliness and Disease Markers in Colorectal Cancer

Inconclusive previous research has hinted at the significance of social support in cancer-related outcomes. Some recent studies have also attempted to show the role of proangiogenic cytokines as the possible underlying mechanisms in this relationship between social support and cancer progression. This thesis aimed to further investigate these pathways by investigating the association between social support, loneliness and disease markers in colorectal cancer. This thesis systematically reviewed the longitudinal prospective findings (N =27) on the relationship between social support and cancer progression, and found that the evidence from methodologically sound studies (n = 16) was strong for breast cancer (67%) but not for other types of cancer (0%) and mixed cancers (50%). It also suggested that disease-related variables should be considered when assessing the role ofpsychosocial factors in cancer-related outcomes. Due to the issues associated with the self-reported assessment of social support and loneliness, this thesis aimed to use an implicit measure ofloneliness, in addition to the conventional explicit measures of social support and loneliness. Therefore, Study 1 adapted and validated an Implicit Association Test ofloneliness (IAT-L). This IAT-L showed low internal consistency, and weak construct and criterion-related validity in this study on 50 healthy volunteers (mean age = 24.1 years). In order to overcome these weaknesses, Study 2 used a modified IAT-L and investigated the relationship between implicit loneliness, social support, and cardiovascular reactivity to stress, to establish its predictive validity in another sample of23 healthy female volunteers (mean age =22.1 years). Results yielded satisfactory internal consistency ofthe modified tool (IAT-L (M), and implicit loneliness was found to be more strongly correlated with cardiovascular reactivity to stress than the explicit measures of social support and loneliness. Finally, Study 3 used the IAT-L (M) to investigate whether implicit loneliness was related with the in situ levels of four important biological markers (three cytokines and oxytocin) along with explicit measures of social support and loneliness in 51 colorectal cancer patients (mean age =68.3 years). Results showed that implicit loneliness explained significant variance in vascular endothelial growth factor (VEGF), extending previous findings with an implicit test. No significant relations were found for other biological markers. Social support and loneliness indices did not show any significant relationship with disease severity markers including stage and tumour size. Overall, this research attempted to make a unique contribution to the fields ofhealth psychology and psychoneuroimmunology. Implications are discussed in terms ofimplicit testing of loneliness with reference to physiological outcomes, and devising targeted psychosocial and immunotherapeutic interventions for cancer patients with low social support.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Familial social support and depression in breast cancer: an exploratory study on a Pakistani sample

This exploratory study investigated the relationship between familial social support and depression in a Pakistani sample of 80 female breast cancer patients, and whether the groups of demographic and medical variables differ on the levels of familial social support and depression. Familial social support and depression were measured by indigenous scales administered in Urdu language and found to be significantly inversely correlated. The groups based on age, number of children, financial sources of treatment, and disease stage differed significantly on familial social support and depression. No significant group differences were found on familial social support and depression between the groups of patients living in joint and nuclear families, and those who had and had not undergone mastectomy. Results are discussed in the respective social and cultural contex

Social support and cancer progression: a systematic review

Objective: the variability in the conceptualization and categorization of social support has resulted in mixed findings regarding its role in cancer progression. This systematic review identifies and summarizes the evidence for the significance of two important indices of social support in progression of different cancers.Method: we used systematic and replicable methods to search, select, and evaluate findings.Results: thirty-one longitudinal prospective findings (in 26 papers) which were selected for inclusion categorized social support into structural and functional support. The types of cancer included in these studies fell into three major categories: breast cancer (16), other cancer (10), and mixed cancers (5). Results suggest that the evidence for the relationship between social support and cancer progression is sufficiently strong for breast cancer as shown by five out of seven methodologically sound studies but consistently unconvincing for other types of cancer or in studies which combined different types of cancer. Structural support indices were found to be more frequently associated with disease progression than the indices of functional support in breast cancer. Disease-related variables such as severity, treatment, nodal status, and site of metastasis were found to be significant predictors of cancer progression, and it is suggested that these variables must be considered when conducting studies on the role of psychosocial factors in cancer-related outcomes including progression.Conclusion: methodological limitations of the studies and counterintuitive findings are discussed, and further conclusive research, particularly randomized controlled trials of social support interventions, is warranted to support the findings of this systematic revie

Movement disorders in patients with schizophrenia and a history of substance abuse

OBJECTIVE: The movement disorders acute dystonia, akathisia, Parkinsonian symptoms and tardive dyskinesia [extrapyramidal side effects (EPSs)] are recognized adverse effects of antipsychotic medication. Previous studies have indicated that substance abuse in patients with schizophrenia can worsen EPS. This study therefore investigated the relationship between drug and alcohol use and EPS in a group of patients with schizophrenia.METHODS: Seventy patients with schizophrenia assessed for drug and alcohol use, global functioning, EPS and suicidality. Chlorpromazine equivalents were correlated to levels of EPS and substance abuse.RESULTS: Current EPS were found in 65% of the sample despite three-quarters of the patients receiving second-generation antipsychotics. An even higher level of patients, 87%, was found to have a history of EPS. A long history of schizophrenia independently predicted presence of any EPS, particularly akathisia, controlling for history of substance abuse which was a non-significant predictor.CONCLUSIONS: History or current use of alcohol or drug abuse did not predict EPS, except for alcohol abuse at the time of diagnosis which was associated with current akathisia. Length of illness was correlated with EPS, whereas suicidality was not linked to akathisia. Neither chlorpromazine equivalent antipsychotic dose nor whether the patient received first-generation or second-generation antipsychotic medication was significantly associated with EPS or substance abuse. Copyright © 2013 John Wiley &amp; Sons, Ltd.<br/

Attentional biases in clinical populations with alcohol use disorders: is co-morbidity ignored?

Objective: to identify how psychiatric co-morbidity was identified and assessed, in studies of attentional bias in clinical samples of patients with alcohol use disorders (AUDs).Design: systematic review methodology was used to identify studies and abstract data on alcohol-related attentional biases and measurement of psychiatric co-morbidity.Results: seventeen papers were identified that met the criteria for inclusion. All but one study were in patients meeting criteria for alcohol dependence. In 10 of the 17 studies, either no mention or minimal statements were made pertaining to possible co-morbid conditions (including other substance use): five excluded patients with psychiatric diagnoses,(variously defined), and two excluded patients on 'psychotropic medication’. Slow response latencies to all word types were found in studies where co-morbid conditions were not considered.Conclusions: despite the high prevalence of psychiatric pathology in patients with AUDs (particularly depression), and the acknowledged impact that this has on aetiology, presentation and outcome, psychiatric co-morbidity has not been consistently measured or described in experimental studies on alcohol-related attentional biases in clinical samples. In order to have an accurate appreciation of the role of attentional biases in patients with AUDs, there needs to be a consistent approach to measuring the co-occurrence of other psychopathology.Further research is needed to assess the impact of co-morbidities on attentional biases in AUDs, to enable the development of more targeted psychological and pharmacological treatment

Relationship between loneliness and Proangiogenic Cytokines in newly diagnosed tumors of colon and rectum

Objective: to investigate the association of serum levels of proangiogenic cytokines with different indices of social support and loneliness by measuring the levels of expression of two important proangiogenic cytokines, vascular endothelial growth factor (VEGF), and interleukin-6 in tumors of colon and rectum. Lack of social support has been prospectively associated with cancer progression. Methods: fifty-one newly diagnosed patients with colorectal tumors (mean age, 68.3 years) completed two measures of loneliness 1 to 2 days before their surgical treatment. The first was an explicit self-report questionnaire, which tapped into negative feelings as a result of low social support. The second was a standardized computer-based task, which measured loneliness implicitly. Immunohistochemical analyses were performed on tumor tissues post surgery to determine the expression of cytokines. Results: logistic regression showed that higher levels of implicit loneliness independently predicted stronger expression of VEGF, controlling for Dukes stage and explicit loneliness, both of which were nonsignificant predictors. No significant relationships were found between the loneliness measures and interleukin-6. Conclusions: the results of this study suggest VEGF to be an angiogenic mechanism through which loneliness may lead to worse cancer-related outcomes. Implications are discussed in terms of devising targeted psychosocial and immunotherapeutic interventions for cancer patients with low social support.<br/