Hunger cues versus the passage of time in the resolution of an approach-avoidance conflict

Two experiments were designed to test the hypothesis that approach-avoidance conflict becomes associated with hunger cues during conflict acquisition in a straight alley runway, and that these cues lose some of their avoidance properties during that period of time spent outside the conflict situation. When the animals are returned to the alley, the avoidance component associated with hunger cues is already extinguished, and the animal makes the goal response. Thirty-six naive male albino rats of the Sprague-Dawley strain were used in experiment I. An approach-avoidance conflict was generated in the traditional manner by first pairing the approach response with food and, after firmly establishing the approach component, pairing it with shock until the animal failed to make any forward movement. In order to insure that the gradients intersected at the same point, Ss were given extinction trials until they moved from 8 to 12 in. down the alley, and matched. They were then randomly assigned to three groups: an alley group, a home-cage satiation group, and a home-cage deprivation group. These designations refer to where the time following the conflict training was spent and, for the home-cage groups, the drive condition (satiation or deprivation) during this period. Trial-by-trial extinction (two trials per day) was administered until the alley group extinguished the avoidance response to the criterion of two successive goal responses. As soon as the alley group reached the criterion, the home-cage groups were placed on 100% deprivation for 24 hours, and subsequently were given all extinction trials in one day until the criterion was reached

It Takes a Team to Make It Through: The Role of Social Support for Survival and Self-Care After Allogeneic Hematopoietic Stem Cell Transplant

Background: Social support plays an important role for health outcomes. Support for those living with chronic conditions may be particularly important for their health, and even for their survival. The role of support for the survival of cancer patients after receiving an allogeneic hematopoietic cell transplant (alloHCT) is understudied. To better understand the link between survival and support, as well as different sources and functions of support, we conducted two studies in alloHCT patients. First, we examined whether social support is related to survival (Study 1). Second, we examined who provides which support and which specific support-related functions and tasks are fulfilled by lay caregivers and healthcare professionals (Study 2). Methods: In Study 1, we conducted a retrospective chart review of alloHCT patients (N = 173, 42.8% female, age: M = 49.88) and registered availability of a dedicated lay caregiver and survival. In Study 2, we prospectively followed patients after alloHCT (N = 28, 46.4% female, age: M = 53.97, 46.4% ethnic minority) from the same hospital, partly overlapping from Study 1, who shared their experiences of support from lay caregivers and healthcare providers in semi-structured in-depth interviews 3 to 6 months after their first hospital discharge. Results: Patients with a dedicated caregiver had a higher probability of surviving to 100 days (86.7%) than patients without a caregiver (69.6%), OR = 2.84, p = 0.042. Study 2 demonstrated the importance of post-transplant support due to patients' emotional needs and complex self-care regimen. The role of lay caregivers extended to many areas of patients' daily lives, including support for attending doctor's appointments, managing medications and financial tasks, physical distancing, and maintaining strict dietary requirements. Healthcare providers mainly fulfilled medical needs and provided informational support, while lay caregivers were the main source of emotional and practical support. Conclusion: The findings highlight the importance of studying support from lay caregivers as well as healthcare providers, to better understand how they work together to support patients' adherence to recommended self-care and survival

Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature

Objective: This article reviews recent literature on adults' quality of life following hematopoietic stem cell transplantation (HSCT). Methods: We identified 22 prospective reports with at least 20 participants at baseline through a search of databases (Medline and PsycInfo) and handsearching of articles published from 2002 to October 2007. If longitudinal data were not available or were scarce for a particular topic or time point, cross-sectional studies were reviewed. Results: Although physical, psychological, and social aspects of quality of life tend to improve during the years following transplantation, a significant proportion of HSCT survivors experience persistent anxiety and depressive symptoms, fatigue, sexual dysfunction, and fertility concerns. Despite ongoing treatment side effects, the majority of HSCT survivors resume their work, school, or household activities. Conclusion: We conclude that theory-driven research with larger samples is needed to identify subgroups of HSCT survivors with adjustment difficulties. Such research would examine survivors' evolving standards and definitions of quality of life to improve the accuracy and meaningfulness of assessment and incorporate biological, psychological, and contextual factors that may contribute to positive adjustment. Copyright © 2008 John Wiley & Sons, Ltd

Quality of life concerns and depression among hematopoietic stem cell transplant survivors

Purpose This study examined quality of life, transplant-related concerns, and depressive symptoms and their demographic and medical correlates at 1 to 3 years following hematopoietic stem cell transplantation (HSCT). Methods HSCT survivors (N = 406) completed telephone-administered questionnaires that assessed demographic variables, functional status, quality of life, transplant-related concerns, and depressive symptoms. Results The most prevalent concerns among HSCT survivors included physical symptoms (e.g., fatigue and pain), maintaining current health status and employment, changes in appearance, and lack of sexual interest and satisfaction. In addition, almost one-third (32%) of survivors age 40 years and younger reported concern about their ability to have children. Unemployed survivors and those with lower incomes and worse functional status were more likely to experience poorer quality of life in multiple domains. Fifteen percent of the sample reported moderate to severe depressive symptoms, and these symptoms were higher among allogeneic transplant recipients and those with lower functional status. Conclusions Results suggest that interventions are needed to address physical symptoms, coping with an uncertain future, infertility, and sexual issues during the early phase of HSCT survivorship

Enacting boundaries or building bridges? Language and engagement in food-energy-water systems science

Scientific study of issues at the nexus of food–energy–water systems (FEWS) requires grappling with multifaceted, “wicked” problems. FEWS involve interactions occurring directly and indirectly across complex and overlapping spatial and temporal scales; they are also imbued with diverse and sometimes conflicting meanings for the human and more-than-human beings that live within them. In this paper, we consider the role of language in the dynamics of boundary work, recognizing that the language often used in stakeholder and community engagement intended to address FEWS science and decision-making constructs boundaries and limits diverse and inclusive participation. In contrast, some language systems provide opportunities to build bridges rather than boundaries in engagement. Based on our experiences with engagement in FEWS science and with Indigenous knowledges and languages, we consider examples of the role of language in reflecting worldviews, values, practices, and interactions in FEWS science and engagement. We particularly focus on Indigenous knowledges from Anishinaabe and the language of Anishinaabemowin, contrasting languages of boundaries and bridges through concrete examples. These examples are used to unpack the argument of this work, which is that scientific research aiming to engage FEWS issues in working landscapes requires grappling with embedded, practical understandings. This perspective demonstrates the importance of grappling with the role of language in creating boundaries or bridges, while recognizing that training in engagement may not critically reflect on the role of language in limiting diversity and inclusivity in engagement efforts. Leaving this reflexive consideration of language unexamined may unknowingly perpetuate boundaries rather than building bridges, thus limiting the effectiveness of engagement that is intended to address wicked problems in working landscapes

Therapeutic alliance in telephone-administered cognitive–behavioral therapy for hematopoietic stem cell transplant survivors.

A strong therapeutic alliance has been found to predict psychotherapeutic treatment success across a variety of therapeutic modalities and patient populations. However, only a few studies have examined therapeutic alliance as a predictor of psychotherapy outcome among cancer survivors, and none have examined this relation in telephone administered cognitive behavioral therapy (T-CBT). This study evaluated the extent to which therapeutic alliance affected psychotherapy outcomes in survivors of hematopoietic stem cell transplantation (HSCT), a treatment for some cancers

Social correlates of distress following hematopoietic stem cell transplantation: Exploring the role of loneliness and cognitive processing

This study investigated whether loneliness and cognitive processing explain the influence of negative (social constraints) and positive (emotional support) relationship qualities on cancer survivors’ distress. Participants were 195 cancer survivors who had undergone hematopoietic stem cell transplantation. Path analysis supported the hypothesis that loneliness and cognitive processing would mediate the association between social constraints and distress. Only loneliness mediated the association between emotional support and distress—an indirect effect significant only when support came from family and friends rather than a partner. Findings suggest that addressing social constraints may enhance cancer survivors’ adjustment

Self-Efficacy Beliefs Mediate the Relationship between Subjective Cognitive Functioning and Physical and Mental Well-Being after Hematopoietic Stem Cell Transplant

Cognitive problems are commonly reported by hematopoietic stem cell transplant (HSCT) survivors, and are associated with poorer physical and mental well-being. It was hypothesized that adverse effects of subjective cognitive impairment occur because cognitive difficulties reduce survivors’ confidence that they can manage HSCT-related symptoms—that is, self-efficacy for symptom management

Economic Survivorship Stress is Associated with Poor Health-Related Quality of Life among Distressed Survivors of Hematopoietic Stem Cell Transplantation

Hematopoietic stem cell transplantation (HSCT) is a demanding cancer treatment associated with enduring physical and psychological complications. Survivors' well-being may be further compromised by exposure to chronic stressors common to this population, including difficulties arising from costly medical care, changes in employment status, and health insurance coverage. Thus, we hypothesized that financial, employment, and insurance stressors (collectively referred to as economic survivorship stressors) would be associated with poorer health-related quality of life (HRQOL) among HSCT survivors

Effectiveness of partner social support predicts enduring psychological distress after hematopoietic stem cell transplantation

Objective: Hematopoietic stem cell transplant (HSCT) survivors who are 1 to 3 years posttransplant are challenged by the need to resume valued social roles and activities—a task that may be complicated by enduring transplant-related psychological distress common in this patient population. The present study investigated whether transplant survivors who receive adequate social support from their spouse or intimate partner experience lower distress. Method: Effects of receiving a greater quantity of partner support (a common approach to studying enacted support) were compared with effects of receiving more effective partner support (i.e., support that more closely matches their needs in terms of its quantity and quality). Men and women (N = 230) who were 1 to 3 years posttransplant completed measures of partner support quantity (Manne & Schnoll, 2001), partner social support effectiveness (Rini & Dunkel Schetter, 2010), and psychological distress (Brief Symptom Inventory; Derogatis & Spencer, 1982). Potential medical and sociodemographic confounds were controlled in analyses. Results: As hypothesized, survivors reported less distress when they received more effective partner support (p < .001). Quantity of partner support was not associated with distress (p = .23). An interaction revealed that when partner support was effective, the quantity of support survivors received was not associated with their distress (p = .90); however, when partner support was ineffective, receiving a greater quantity of partner support was associated with substantially elevated distress (p = .002). Conclusions: Findings suggest that clinical approaches to addressing or preventing enduring distress after HSCT should target features of partner support related to its appraised effectiveness