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

Exercise and nutrition for head and neck cancer patients: a patient oriented, clinic-supported randomized controlled trial

Abstract Background Research on physical activity and nutrition interventions aimed at positively impacting symptom management, treatment-related recovery and quality of life has largely excluded head and neck (HN) cancer populations. This translates into a lack of clinical programming available for these patient populations. HN cancer patients deal with severe weight loss, with more than 70% attributed to lean muscle wasting, leading to extended recovery times, decreased quality of life (QoL), and impaired physical functioning. To date, interventions to address body composition issues have focused solely on diet, despite findings that nutritional therapy alone is insufficient to mitigate changes. A combined physical activity and nutrition intervention, that also incorporates important educational components known to positively impact behaviour change, is warranted for this population. Our pilot work suggests that there is large patient demand and clinic support from the health care professionals for a comprehensive program. Methods/Design Therefore, the purpose of the present study is to examine the impact and timing of a 12-week PA and nutrition intervention (either during or following treatment) for HN cancer patients on body composition, recovery, serum inflammatory markers and quality of life. In addition, we will examine the impact of a 12-week maintenance program, delivered immediately following the intervention, on adherence, patient-reported outcomes (i.e., management of both physical and psychosocial treatment-related symptoms and side-effects), as well as return to work. Discussion This research will facilitate advancements in patient wellness, survivorship, and autonomy, and carve the path for a physical-activity and wellness-education model that can be implemented in other cancer centers. Trial registration Current Controlled Trials NCT01681654</p

Exercise and nutrition for head and neck cancer patients: a patient oriented, clinic-supported randomized controlled trial

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

Illustrating the Multi-Faceted Dimensions of Group Therapy and Support for Cancer Patients

In cancer support groups, choice of therapy model, leadership style, and format can impact patients’ experiences and outcomes. Methodologies that illustrate the complexity of patients’ group experiences might aid in choosing group style, or testing therapeutic mechanisms. We used this naturalistic study as a beginning step to explore methods for comparing cancer group contexts by first modifying a group-experience survey to be cancer-specific (Group Experience Questionnaire (GEQ)). Hypothesizing that therapist-led (TL) would differ from non-therapist-led (NTL), we explored the GEQ’s multiple dimensions. A total of 292 patients attending three types of groups completed it: 2 TL groups differing in therapy style ((1) Supportive-Expressive (SET); (2) The Wellness Community (TWC/CSC)); (3) a NTL group. Participants rated the importance of “Expressing True Feelings” and “Discussing Sexual Concerns” higher in TL than NTL groups and “Discussing Sexual Concerns” higher in SET than other groups. They rated “Developing a New Attitude” higher in TWC/CSC compared to NTL. In addition, we depict the constellation of group qualities using radar-charts to assist visualization. These charts facilitate a quick look at a therapy model’s strengths and weaknesses. Using a measure like the GEQ and this visualization technique could enable health-service decision making about choice of therapy model to offer

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