The risk of telling : a dyadic perspective on romantic partners' responses to child sexual abuse disclosure and their associations with sexual and relationship satisfaction

Essai présenté à la Faculté des arts et des sciences en vue de l'obtention du grade de Doctorat en psychologie clinique (D. Psy.)Les survivants d’agression sexuelle à l’enfance (ASE) doivent souvent composer avec les conséquences à long terme de ce trauma. Toutefois, il existe une grande variabilité quant aux impacts individuels de l’ASE. Certains auteurs croient que la réponse obtenue lors du dévoilement de l’ASE aux proches du survivant, pourrait être l’un des déterminants de cette variabilité. Cependant, le dévoilement à l’âge adulte, notamment au partenaire amoureux, a été peu étudié. La présente étude examine les associations entre les réponses des partenaires amoureux au dévoilement, tels que perçues par les survivants, ainsi que la satisfaction sexuelle et conjugale des deux membres du couple, auprès d’un échantillon de 70 couples de la communauté ayant rapporté une ASE et l’ayant dévoilée à leur partenaire. Les participants ont complété des questionnaires auto-rapportés en ligne. Les résultats d’analyses de trajectoire au sein d’un modèle « Actor-Partner Interdependence Model » (APIM) indiquent que les réponses de « soutien émotionnel » de la part des partenaires durant le dévoilement, telles que perçues par les survivants, étaient positivement associées à leur propre satisfaction sexuelle ainsi qu’à celle de leur partenaire. Les réponses de « stigmatisation/se sentir traité différemment » de la part des partenaires, telles que perçues par les survivants, étaient associées à une moins bonne satisfaction conjugale, à la fois pour les survivants et leurs partenaires. Les résultats suggèrent que les réponses des partenaires au dévoilement d’une ASE, tels que perçues par les survivants, peuvent avoir un impact positif autant que négatif sur la satisfaction conjugale et sexuelle des deux partenaires.Survivors of childhood sexual abuse (CSA) often experience adverse trauma-related long term consequences, which vary widely among survivors. Some authors argued that this variability might be explained in part by the response of others to survivors’ disclosure of the CSA. However, disclosure during adulthood has received little empirical attention, in particular, disclosure to a romantic partner. Among 70 community couples who reported CSA and disclosure to their partner, this study examined associations between survivors’ perception of partner responses to their disclosure, and both partners’ sexual and relationship satisfaction. Participants completed self-report questionnaires online. Results of path analyses within an actor-partner interdependence model indicated that survivors’ perceived partner responses of emotional support to disclosure were associated with their own and their partners' higher sexual satisfaction. Survivors’ perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners’ poorer relationship satisfaction. Findings suggest that survivor-perceived partner responses to the disclosure of CSA can have both a positive and a negative impact on the sexual and relationship satisfaction of both partners

Impact of smoking status on health-related quality of life (HRQoL) in cancer survivors

IntroductionThe Health-Related Quality of Life (HRQoL) often declines among cancer survivors due to many factors. Some cancer patients who smoke before the cancer diagnosis continue this harmful habit, potentially contributing to a more significant decline in their HRQoL. Therefore, this study investigates the association between smoking status and HRQoL in cancer survivors.MethodsWe conducted a cross-sectional study utilizing self-reported cancer history from 39,578 participants of the Behavioral Risk Factor Surveillance System (BRFSS) database, leveraging 2016 and 2020 year questionaries. A multidimensional composite outcome was created to assess HRQoL, integrating four distinct dimensions - general health, mental health, physical health, and activity limitations. After accounting for the complex survey design, logistic regression models were used to analyze the association between smoking status and poor HRQoL, adjusting for demographic, socioeconomic, and health-related confounders.ResultsOur study found that, after adjusting for potential confounders, current smokers exhibited a significantly poorer HRQoL than never smokers (OR 1.65, 95%CI 1.40-1.93). Furthermore, former smokers showed a poorer HRQoL than never smokers; however, this association was not as strong as current smokers (OR 1.22, 95%CI 1.09-1.38).ConclusionOur findings highlight the adverse association of smoking with poor HRQoL in cancer survivors, underscoring the importance of healthcare professionals prioritizing smoking cessation and providing tailored interventions to support this goal

Expert elicitation to inform a cost effectiveness analysis of screening for renal cancer: methodological and practical considerations

Background: Population screening for renal cell carcinoma (RCC) using ultrasound has the potential to improve survival outcomes; however a cost-effectiveness analysis (CEA) has yet to be performed. Due to the lack of existing evidence, we performed structured expert elicitation to derive unknown quantities to inform the CEA. Objectives: To elicit the cancer stage distribution (proportion of individuals with each stage of cancer) for different RCC screening scenarios and the annual transition probabilities for undiagnosed disease becoming diagnosed in the NHS. Methods: The study design and reporting adhered to the Reporting Guidelines for the Use of Expert Judgement in Model-Based Economic Evaluations. The elicitation was conducted face-to-face or via telephone between each individual expert and the facilitator, aided by online material. For multinomial data, Connor Mosimann and modified Connor Mosimann distributions were fitted for each expert and for all experts combined using mathematical linear pooling. Results: A total of 24 clinical experts were invited, and 71% participated (7 urologists, 6 oncologists, 4 radiologists). The modified Connor Mosimann distribution provided the best fit for the majority of elicited quantities. Greater uncertainty was noted for the elicited transition probabilities compared to the elicited stage distributions. Conclusion: We performed the first expert elicitation of RCC screening parameters, crucial information which will inform the CEA of screening. Additionally, the elicited quantities may enable future health economic evaluations assessing the value of diagnostic tools and pathways in RCC

Predictors of chronic posttraumatic stress disorder and revictimization in sexual assault survivors.

Predictors of chronic posttraumatic stress disorder and revictimization in sexual assault survivors

Achieving Grand Tour success : a pilot study using cycling's World Tour points

BACKGROUND: In cycling, the Union Cycliste International (UCI) World Tour points system provides a basis to assess the development of riders by longitudinally monitoring accumulated points. The main aim of the present analysis was to compare the annual aggregation of points of Grand Tours (GT) contenders during the years before and the year after achieving an overall top-ten (T10) placing in a GT for the first time. METHODS: Data from professional cyclists who achieved their first T10 GC result in a GT between 2010 and 2015, inclusive, were included in the analysis. RESULTS: There were 43 cyclists who achieved a T10 placing for the first time between 2010 and 2015, with an average number of UCI points of 139.7 \ub177.1 points. Of these cyclists, 20 placed within the top five (T5), and averaged 183.1 \ub171.6 UCI points within the T5 season. There was a significant difference in the number of points accumulated in the T5/T10 between the T5 and T10 groups (p<0.05), however there were no significant differences between the groups in the other seasons. CONCLUSIONS: An apparent spike in the number of points obtained in the T5 or T10 season when compared to the preceding seasons may be due to successful riders being afforded more opportunities to play leading roles within the team. This effect may have persisted into the season following the T5/T10 finish