For I Know the Plans I Have for You: God Locus of Control, Spiritual Change, and Death Anxiety in Primary Brain Tumor Patients

Background/Purpose. Primary brain tumor (PBT) patients risk experiencing death anxiety given the high mortality rate of their diagnosis. In line with Terror Management Theory (TMT), many diagnosed with cancer utilize religion as a method of coping with the disease. However, previous literature on the relation between death anxiety and religion in cancer patients indicates mixed findings of either a negative relationship or no association. To the authors’ knowledge, no study has analyzed these two constructs together in PBT patients. The current study sought to address this gap by investigating the relationship between religiosity and death anxiety in an understudied population. Methods. Adult PBT patients (N = 56, Mage = 49.38, 51.8% female, 71.4% Caucasian, Mmonths since diagnosis = 55.34) completed measures of religiosity and death anxiety at their routine medical appointment at an academic medical center, including: The God Locus of Health Control Scale (GLHCS), Posttraumatic Growth Inventory (PTGI), Death and Dying Distress Scale (DADDS), and the Death Distress Scale (DDS). Descriptives and Pearson correlations were utilized. Results. The results revealed that while the GLHCS was not significantly related to either measure of death anxiety, the Spiritual Change subscale of the PTGI was positively correlated to both the DADDS (r = .56, p \u3c .001) and the DDS (r = .41, p = .01). Conclusions and Implications. Results suggest that certain proxies of religiosity may be more closely associated with death anxiety than others. Although there was no evidence in our sample that PBT patient’s God locus of control was related to death anxiety, those who reported higher levels of death anxiety endorsed greater spiritual change (i.e., I have a stronger religious faith). Considering TMT, perhaps feelings of death anxiety prompt one to strengthen their religious beliefs. Future longitudinal analyses addressing the direction and course of these relationships are warranted. Acknowledgement of Funding: The current study was funded on behalf of Virginia Commonwealth University School of Medicine. Learning Objective. Participants will learn about the relationship between religiosity and death anxiety in oncology patients. Further, participants will consider how these findings may or may not differ for PBT patients and across various measures of religiosity.https://scholarscompass.vcu.edu/gradposters/1049/thumbnail.jp

Screening for Cognitive Impairment in Primary Brain Tumor Patients: A Preliminary Investigation with the MMSE and RBANS

Introduction: The prevalence of mild cognition impairment (MCI) among older adults (≥65) is estimated to range between 10-20% (Langa & Levine, 2014). Integrated primary care allows opportunities for interdisciplinary consultation, screening, and intervention. The aim of this study is to explore the percentage of older adults reporting cognitive concerns during their first primary care psychology visits. It is hypothesized that these rates will mirror prevalence rates in other older adult community dwelling samples in primary care settings. Methods: A patient sample of older adults (≥60) was introduced to services following a referral from their primary care physician. Clinicians then identified problems that were discussed in session, including “cognitive concerns.” Descriptive statistics will be used to assess the percentage of older adults with “cognitive concerns” in this sample, compared to other community dwelling samples. Results: 267 older adults were identified within a larger sample of patients who received primary care psychology services. The percentage of older adults who were referred for “cognitive concerns” was 10.5% (n = 28), with 12.7% (n = 34) reporting “cognitive concerns” during their visit. Interestingly of the 28 older adults referred by their provider for “cognitive concerns,” less than 50% (n = 13) of those patients reported “cognitive concerns” as one of their problems in session. Discussion: This sample of older adults reported cognitive concerns in primary care psychology sessions at a rate that falls within the range identified in other community dwelling samples. Future research could further improve upon identification and screening of older adults with cognitive concerns by psychologists in primary care settings, as intervention for MCI can improve quality of life and may delay progression of dementia (Campbell et al., 2018; Eshkoor et al., 2015).https://scholarscompass.vcu.edu/gradposters/1088/thumbnail.jp

Study protocol for Cognitive Behavioral Therapy for Insomnia in patients with primary brain tumor: A single-arm phase 2a proof-of-concept trial

Background: Sleep disturbance is among the most common symptoms endorsed by patients with primary brain tumor (PwPBT), with many reporting clinically elevated insomnia and poor management of their sleep-related symptoms by their medical team. Though Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the front-line treatment for sleep disturbance, CBT-I has yet to be evaluated in PwPBT. Thus, it is unknown whether CBT-I is feasible, acceptable, or safe for patients with primary brain tumors. Methods: PwPBT (N = 44) will enroll and participate in a six-week group-based CBT-I intervention delivered via telehealth. Feasibility will be based on pre-determined metrics of eligibility, rates and reasons for ineligibility, enrollment, and questionnaire completion. Acceptability will be measured by participant retention, session attendance, satisfaction ratings, and recommendation to others. Safety will be assessed by adverse event reporting. Sleep will be measured both objectively via wrist-worn actigraphy and subjectively via self-report. Participants will also complete psychosocial questionnaires at baseline, post-intervention, and three-month follow-up. Conclusion: CBT-I, a non-pharmacological treatment option for insomnia, has the potential to be beneficial for an at-risk, underserved population: PwPBT. This trial will be the first to assess feasibility, acceptability, and safety of CBT-I in PwPBT. If successful, this protocol will be implemented in a more rigorous phase 2b randomized feasibility pilot with the aim of widespread implementation of CBT-I in neuro-oncology clinics

Results of a culturally relevant, physical activity-based wellness program for urban Indigenous women in Alberta, Canada

Increasing physical activity and improving nutrition is challenging for Indigenous women. Their lives are complex and influenced by sociopolitical structures and racism that have yielded family breakdown, socioeconomic inequality, and high levels of poor health. Women Warriors (WW), an eight-week physical activity-based wellness program, was designed to support Indigenous women in their efforts to increase physical activity levels, improve nutrition, and develop support systems to produce good health. To evaluate the impact of the program, we completed a mixed method pre/post evaluation of four program sessions, from January to December 2016. The WW program resulted in increased weekly pedometer step counts, increased nutrition skill acquisition, and improved confidence in exercising as a group and increasing fruit and vegetable consumption. It also produced demonstrable improvements in anthropometrics. Participants developed positive social support systems and learned about the health and social resources available to them in their community. They appreciated that the program motivated them by keeping them accountable and offered opportunity to share their experiences in the context of the sharing circle. The program identified barriers to health change, including lack of resources that support physical activity, healthy eating, and personal stress management. Participants recommended that future programs increase in duration and intensity and offer enhanced nutrition and health education, increased avenues for support system development, and opportunities to network outside of the program. The WW program was well received and shows promise as a practical, community-based method to provide support to Indigenous women interested in increasing positive health behaviours

COVID‐19 and Religious Ethics

The editors of the JRE solicited short essays on the COVID-19 pandemic from a group of scholars of religious ethics that reflected on how the field might help them make sense of the complex religious, cultural, ethical, and political implications of the pandemic, and on how the pandemic might shape the future of religious ethics

Correlates of excessive daytime sleepiness in de novo Parkinson's disease: A case control study

Objective: This study was undertaken to determine the frequency and correlates of excessive daytime sleepiness in de novo, untreated Parkinson's disease (PD) patients compared with the matched healthy controls. Methods: Data were obtained from the Parkinson's Progression Markers Initiative, an international study of de novo, untreated PD patients and healthy controls. At baseline, participants were assessed with a wide range of motor and nonmotor scales, including the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Excessive daytime sleepiness was assessed based on the Epworth Sleepiness scale (ESS), with a cutoff of 10. Results: Four hundred twenty-three PD subjects and 196 healthy controls were recruited into the study. Mean ESS (min, max) score was 5.8 (0, 20) for the PD subjects and 5.6 (0, 19) for healthy controls (P=0.54). Sixty-six (15.6%) PD subjects and 24 (12%) healthy controls had ESS of at least 10 (P=0.28). No difference was seen in demographic characteristics, age of onset, disease duration, PD subtype, cognitive status, or utilization of sedatives between the PD sleepiness-positive versus the negative group. The sleepiness-positive group had higher MDS-UPDRS Part I and II but not III scores, and higher depression and autonomic dysfunction scores. Sleepiness was associated with a marginal reduction of A-beta (P=0.05) but not alpha-synuclein spinal fluid levels in PD. Conclusions: This largest case control study demonstrates no difference in prevalence of excessive sleepiness in subjects with de novo untreated PD compared with healthy controls. The only clinical correlates of sleepiness were mood and autonomic dysfunction. Ongoing longitudinal analyses will be essential to further examine clinical and biological correlates of sleepiness in PD and specifically the role of dopaminergic therapy