A.J.J.M. Vingerhoets

Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer

The aim of this study was to investigate the nature and severity of the arm complaints among breast cancer patients after axillary lymph node dissection (ALND) and to study the effects of this treatment-related morbidity on daily life and well-being. 400 women, who underwent ALND as part of breast cancer surgery, filled out a treatment-specific quality of life questionnaire. The mean time since ALND was 4.7 years (range 0.3-28 years). More than 20% of patients reported pain, numbness, or loss of strength and 9% reported severe oedema. None of the complaints appeared to diminish over time. Irradiation of the axilla and supraclavicular irradiation were associated with a 3.57-fold higher risk of oedema (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.66-7.69) causing many patients to give up leisure activities or sport. Women who underwent irradiation of the breast or chest wall more often reported to have a sensitive scar than women who did not receive radiotherapy. Women <45 years of age had an approximately 6 times higher risk of numbness of the arm (OR 6.49; 95% CI 2.58-16.38) compared with those > or = 65 years of age; they also encountered more problems doing their household chores. The results of the present study support the introduction of less invasive techniques for the staging of the axilla, sentinel node biopsy being the most promising.

The past makes the present meaningful: nostalgia as an existential resource

The present research tested the proposition that nostalgia serves an existential function by bolstering a sense of meaning in life. Study 1 found that nostalgia was positively associated with a sense of meaning in life. Study 2 experimentally demonstrated that nostalgia increases a sense of meaning in life. In both studies, the link between nostalgia and increased meaning in life was mediated by feelings of social connectedness. Study 3 evidenced that threatened meaning increases nostalgia. Study 4 illustrated that nostalgia, in turn, reduces defensiveness following a meaning threat. Finally, Studies 5 and 6 showed that nostalgia disrupts the link between meaning deficits and compromised psychological well-being. Collectively, these findings indicate that the provision of existential meaning is a pivotal function of nostalgia.

Spirituality and well-being in cancer patients: a review

Objective: Cancer places many demands on the patient and threatens the persons sense of meaning to life. It has been shown that cancer patients use their spirituality to cope with these experiences. The present literature review summarizes the research findings on the relationship between spirituality and emotional well‐being. Special attention is given to the strength of the research findings.

Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors.

This study evaluates posttraumatic growth, benefit finding and well-being, and their mutual association in a random sample of disease-free 10-year breast cancer survivors. The population-based Eindhoven Cancer Registry (ECR) was used to select all women diagnosed with breast cancer in 1993 in six hospitals. Of the 254 breast cancer survivors, 183 (72%) returned a completed questionnaire. Measures included the Posttraumatic Growth Inventory (posttraumatic growth), the Perceived Disease Impact Scale (benefit finding) and the CentERdata Health monitor (life satisfaction, health status and psychological well-being). Self-reported health status and psychological well-being were similar in survivors compared to general population norms, whereas life satisfaction was significantly higher among survivors. In addition, posttraumatic growth was seen in the following domains: relationships with others, personal strength and appreciation of life. The number of patients reporting benefit finding was high (79%, N = 145). Benefit finding showed a moderately positive correlation with posttraumatic growth. In addition, women who stated that their satisfaction with life was high reported higher levels of posttraumatic growth in comparison to women who did not. Radiotherapy was negatively associated with posttraumatic growth. Women with a higher tumour stage at diagnosis experienced less benefit finding in comparison to women with a lower tumour stage at diagnosis. The above results can help to identify those patients who will probably experience posttraumatic growth and benefit finding after cancer. However, it is important to be aware that the positive effects of cancer on a patients life do not occur in all cancer patients and all phases of the disease trajectory.

Vacationers Happier, but Most not Happier After a Holiday

The aim of this study was to obtain a greater insight into the association between vacations and happiness. We examined whether vacationers differ in happiness, compared to those not going on holiday, and if a holiday trip boosts post-trip happiness. These questions were addressed in a pre-test/post-test design study among 1,530 Dutch individuals. 974 vacationers answered questions about their happiness before and after a holiday trip. Vacationers reported a higher degree of pre-trip happiness, compared to non-vacationers, possibly because they are anticipating their holiday. Only a very relaxed holiday trip boosts vacationers’ happiness further after return. Generally, there is no difference between vacationers’ and non-vacationers’ post-trip happiness. The findings are explained in the light of set-point theory, need theory and comparison theory.

Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer.

The aim was to explore measurements of arm circumference and shoulder abduction as indicators of quality of life after axillary lymph node dissection for invasive breast cancer.

Influence of perceived psychological stress and distress on antibody response to low dose rDNA hepatitis B vaccine.

The present study focused on the relationship between psychological stress and immune reaction to a novel antigen. Participants completed questionnaires on daily hassles, psychoneurotic complaints, coping style, and loneliness, 2 and 6 months after the first of a series injections with a low dose recombinant DNA hepatitis B vaccine. Antibody response was determined 7 months after the first vaccination. Based on the psychological questionnaires two different stress measures were calculated: a Stress Index score-month-2 and a Stress Index score-month-6 indicating stress levels experienced at the beginning and at the end of the study respectively. Antibody levels were found to be negatively related with the Stress Index score-month-2. Although the influence of psychological stress reported on month 6 tended to be in the same direction, this effect was not significant. Coping styles and loneliness were not associated with antibody formation. These results suggest that antibody formation to rDNA hepatitis B vaccine is negatively influenced by psychological stress.

CNV and EMG preceding a plantar flexion of the foot

In 25 subjects CNV and EMG were recorded during a reaction time experiment with a fixed 4 sec foreperiod. The response was plantar flexion of the right foot. EEGs were recorded with four electrodes from the central area, two over each hemisphere. CNV amplitudes were larger over the ipsilateral than over the contralateral hemisphere. Amplitudes were smaller in the more lateral derivations. The late component of the CNV showed larger amplitudes when preceding relatively fast responses. EMG activity was recorded from the calf muscles of both legs. In the left leg it was not different during the intertrial interval and the foreperiod. A small but systematic increase in EMG activity was found during the foreperiod in the right leg. The increase was larger preceding fast responses, parallel to the amplitude changes in CNV late waves.

Back to the Future: Nostalgia Increases Optimism

This research examined the proposition that nostalgia is not simply a past-oriented emotion, but its scope extends into the future, and, in particular, a positive future. We adopted a convergent validation approach, using multiple methods to assess the relation between nostalgia and optimism. Study 1 tested whether nostalgic narratives entail traces of optimism; indeed, nostalgic (compared with ordinary) narratives contained more expressions of optimism. Study 2 manipulated nostalgia through the recollection of nostalgic (vs. ordinary) events, and showed that nostalgia boosts optimism. Study 3 demonstrated that the effect of nostalgia (induced with nomothetically relevant songs) on optimism is mediated by self-esteem. Finally, Study 4 established that nostalgia (induced with idiographically relevant lyrics) fosters social connectedness, which subsequently increases self-esteem, which then boosts optimism. The nostalgic experience is inherently optimistic and paints a subjectively rosier future.

Homesickness: a review of the literature

Homesickness has not received due attention from psychological researchers, in spite of the fact that it is of considerable interest to counsellors and care-givers of those who have migrated or moved temporarily or permanently (e.g. immigrants, refugees, students, soldiers). First, this review addresses the definition of homesickness, the possible different kinds of homesickness, its prevalence rate, and symptomatology, Secondly, an overview is given of the theories that account for psychological distress following leaving home. These theories link homesickness with separation-anxiety and loss, the interruption of lifestyle, reduced control, role change, and internal conflict. In addition, the review focuses on: (i) studies that show that subjects reporting homesickness differ from non-homesick persons in terms of personality; (ii) the analyses of environmental characteristics that may play a crucial role in the onset and course of homesickness. Thirdly, Fishers (1989) composite model of homesickness, which summarizes key findings of the major studies on homesickness is discussed. Fourthly, methodological issues are addressed. Finally, suggestions for future research are presented and possibilities for interventions are proposed.