The concept of conflict in health psychology: Person by situation measurement

The current study utilized newly-developed idiographic measurement techniques assessing several types of psychological conflict in a short-longitudinal prospective design to investigate differences in chronic illness versus no-chronic-illness controls and to assess the power of these conflict measures in predicting health outcomes. In particular, Emmons' (1986) Personal Strivings Matrix, which measures personal-striving incompatibilities, and Higgins, Klein, and Strauman's (1985) Selves Questionnaire, which measures discrepancies between actual, ideal, and ought self-concepts, could be seen to approximate closely earlier theorizing regarding the effect of internal conflict on health. The purpose of the current study was primarily to develop a daily-measurement device capable of assessing inner conflict and secondarily to test out this device with a sample of chronic-illness groups and no-chronic-illness controls. The long-term goal of this research is to develop intervention strategies which utilize such daily-monitoring techniques with individual clients. These techniques would allow the therapist/client pair to assess the coincidence of inner conflict and illness exacerbations, and would allow the client to monitor positive change in self-concept. The current study included initial assessment with these Selves and Strivings measures, daily diaries (90 days) which included daily forms of these measures, and post-test administration.Results indicated that migraine, GI Disorders, and allergy illness groups could be discriminated in interesting ways which were consistent with longstanding hypotheses. Migraineurs were consistently discrepant from their Actual/Ought self-guides. GI Disorder subjects were marginally discrepant both from Actual/Ideal Own and Actual/Ought self guides. Allergy subjects, who have been found in previous research to have a high incidence of depression, were higher in Actual/Ideal Own conflict which has been linked with chronic depression. Some health outcomes were successfully predicted by conflict measures. In particular, Post-Test Selves and Stress/Conflicted factors predicted daily physical symptom mean and health-center visits for the total sample.U of I OnlyETDs are only available to UIUC Users without author permissio

Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer

Cancer treatment is known to have significant immuno-suppressive/dysregulatory effects. Psychological distress and depression, which often accompany cancer diagnosis and treatment, can also suppress or dysregulate endocrine and immune function. Cell-mediated immunity (CMI) is critical for protection against a host of pathogens to which cancer patients may be particularly susceptible. CMI is also important for defense against some tumors. This study explored relationships among depressive symptoms, cortisol secretion, and CMI responses in 72 women with metastatic breast cancer. Depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Scale (CES-D). Saliva was sampled throughout the day over a 3-day period to obtain a physiologic index of diurnal cortisol concentrations and rhythmicity, which is associated with breast cancer survival time. CMI for specific antigens was measured following intradermal administration of seven commonly encountered antigens (tuberculin, tetanus, diphtheria, Streptococcus, Candida, Trichophyton, and Proteus). Analyses adjusting for relevant medical and treatment variables indicated that women reporting more depressive symptoms showed suppressed immunity as measured by lower average induration size. Women with higher mean diurnal cortisol concentrations also showed suppressed immunity as indicated by a decreased number of antigens to which positive reactions were measured. This study highlights the relationships among depression, stress, and immune function in the context of advanced breast cancer

Mindfulness-based cancer recovery and supportive-expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors

Group psychosocial interventions including mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET) can help breast cancer survivors decrease distress and influence cortisol levels. Although telomere length (TL) has been associated with breast cancer prognosis, the impact of these two interventions on TL has not been studied to date

Screening for distress, the 6th vital sign: common problems in cancer outpatients over one year in usual care: associations with marital status, sex, and age

Article deposited according to agreement with BMC, December 2, 2010 and according to publisher policies: http://www.biomedcentral.com/about/copyright [May 31, 2013].YesFunding provided by the Open Access Authors Fund

Documenting patients’ and providers’ preferences when proposing a randomized controlled trial: a qualitative exploration

Abstract Background With advances in cancer diagnosis and treatment, women with early-stage breast cancer (ESBC) are living longer, increasing the number of patients receiving post-treatment follow-up care. Best-practice survivorship models recommend transitioning ESBC patients from oncology-provider (OP) care to community-based care. While developing materials for a future randomized controlled trial (RCT) to test the feasibility of a nurse-led Telephone Survivorship Clinic (TSC) for a smooth transition of ESBC survivors to follow-up care, we explored patients’ and OPs’ reactions to several of our proposed methods. Methods We used a qualitative study design with thematic analysis and a two-pronged approach. We interviewed OPs, seeking feedback on ways to recruit their ESBC patients for the trial, and ESBC patients, seeking input on a questionnaire package assessing outcomes and processes in the trial. Results OPs identified facilitators and barriers and offered suggestions for study design and recruitment process improvement. Facilitators included the novelty and utility of the study and simplicity of methods; barriers included lack of coordination between treating and discharging clinicians, time constraints, language barriers, motivation, and using a paper-based referral letter. OPs suggested using a combination of electronic and paper referral letters and supporting clinicians to help with recruitment. Patient advisors reported satisfaction with the content and length of the assessment package. However, they questioned the relevance of some questions (childhood trauma) while adding questions about trust in physicians and proximity to primary-care providers. Conclusions OPs and patient advisors rated our methods for the proposed trial highly for their simplicity and relevance then suggested changes. These findings document processes that could be effective for cancer-patient recruitment in survivorship clinical trials