The role of spousal supportive behaviors in couples' adaptation to colorectal cancer

The diagnosis of cancer begins a period of significant distress and adjustment for both patients and their partners. To cope better with the distress, both partners are expected to support each other. However, this is not always the case and sometimes even well-meant support may hamper adjustment. This thesis describes the role of interpersonal factors (i.e., past spousal support) and intrapersonal (e.g., personal control) in the association between spousal support and wellbeing of couples coping with colorectal cancer. The results suggest that overall people who perceived their partner to be supportive in the past, had a high sense of personal control and/or had a low need for emotional expression were less affected by their partners’ current behavior compared to people who perceived their partners not to be supportive in the past, had a low sense of personal control and/or had a high need for emotional expression. As more studies examine couples’ adjustment to cancer, the challenges of recruiting both members of the dyad to studies are becoming apparent. Hence, the second part of this thesis focuses on a common methodological issue; namely, couples recruitment to psycho-oncological studies. A systematic review was conducted to examine the average Couples Response Rates (CRR), systematically review the quality of reporting of couples’ response rate, and assess potential determinants of this rate in studies of couples coping with cancer. The results revealed incomplete reporting of response rate and potential determents of CRR. Recommendations and guidelines to improve reporting are provided

Relationship satisfaction in couples confronted with colorectal cancer: the interplay of past and current spousal support

Based on attribution theory, this study hypthesized that past spousal supportiveness may act as a moderator of the link between one partner’s current support behavior and the other partner’s relationship satisfaction. A sample of 88 patients with colorectal cancer and their partners completed questionnaires approximately 3 and 9 months after diagnosis. The data were analyzed employing dyadic data analytic approaches. In the short-term, spousal active engagement—which involved discussing feelings and engaging in joint problem solving—was positively associated with relationship satisfaction in patients as well as in partners, but only when past spousal support was relatively low. Spousal protective buffering—which involved hiding worries and fears and avoiding talking about the disease—was negatively associated with relationship satisfaction in patients, again only when past spousal support was relatively low. If past spousal support was high, participants rated the quality of their relationship relatively high, regardless of their partner’s current support behavior. Over time, past spousal supportiveness was not found to mitigate the negative association between spousal protective buffering and relationship satisfaction. Overall, our results indicate that relationship satisfaction can be maintained if past spousal supportiveness is high even if the partner is currently not very responsive to the individual’s needs, at least in the short-term

Response Rates in Studies of Couples Coping With Cancer: A Systematic Review

Objective: Recruiting couples for psychological studies can be challenging. This brief report is the first to examine the average couples' response rate and to systematically review the quality of reporting of couples' response rate in studies of couples coping with cancer. Method: A systematic review (1980-2011) was conducted, including 83 studies meeting the inclusion criteria of being published in peer-reviewed journals, describing quantitative findings using a cross-sectional or longitudinal design. Results: Overall reporting was unsatisfactory in more than half of the included studies. As a consequence, the couples' response rate (CRR; all analyzed couples divided by the number of eligible partnered patients/couples approached) could be calculated for only 33 samples. This CRR varied considerably across studies from 25% to 90% (CRRM = 58%, SD = 17%). The rates reported in the articles (M = 65%) were often higher than the average CRR (CRRM = 57%) of these samples. Conclusions: This systematic review revealed incomplete reporting of response rate. Therefore, it cannot be firmly concluded that the average CRR reported is representative for all studies on couples coping with cancer. Finally, the figures presented, which are often more favorable than the CRR, may create the impression that the sample is more representative of the target population than it actually is. This has consequences for implementing the findings of such studies into practice. The results are critically discussed, and recommendations for improvement are provided

Cancer Biomarker Discovery and Development in Gastrointestinal Cancers: Early Detection Research Network—A Collaborative Approach

Despite the large amount of research and reporting on potential biomarkers in cancer, very few markers have been brought to use in the clinic. Disorganization plays a large part in this low yield. The Early Detection Research Network (EDRN) of the National Cancer Institute has been initiated to foster collaboration among independent institutions/ laboratories to facilitate, standardize, and centralize discovery and validation of candidate biomarkers. EDRN comprises four components: biomarker reference laboratories; biomarker developmental laboratories; clinical epidemiology and validation centers; and a data management and coordinating center. Biomarker validation proceeds through five phases—the preclinical exploratory, clinical assay and validation, retrospective longitudinal, prospective screening, and cancer control phases. A number of candidate markers in colon cancer, esophageal adenocarcinoma, and hepatocellular carcinoma (HCC) currently are moving through the developmental process. Ongoing EDRN collaborations assessing the potential utility of des-gamma carboxyprothrombin (DCP) in discriminating early HCC in patients with cirrhosis and the ability of DNA methylation analysis to predict progression from Barrett’s esophagus to esophageal cancer are summarized. EDRN welcomes collaboration in biomarker validation and assembly of sample reference libraries

The interplay between partners' responsiveness and patients' need for emotional expression in couples coping with cancer

The central aim of this longitudinal observational study was to test whether patients with a high need for emotional expression are especially sensitive to their partners' responsive behavior, and therefore at risk for depressive symptoms when responsiveness is withheld. Patients with colorectal cancer and their partners (n = 58) participated in a longitudinal study (3, 5 and 9 months after the diagnosis). Additionally to self-report measurements (i.e., patients' need for emotional expression, patients' depressive symptoms and patients' relationship satisfaction) couples were videotaped discussing cancer-related concerns. External observers coded partners' responsiveness (i.e., understanding, validation and caring) and patients' self-disclosures. Partner responsiveness predicted lower levels of depressive symptoms over time in patients who had a relatively high need for emotional expression above and beyond the effect of relationship satisfaction. We demonstrated that partners' understanding and validation are more important in explaining patients' depressive symptoms than partners' caring behavior. Our findings highlight the importance of the relational context in improving adaptation to cancer taking into account individual differences