Andrea Floyd

Mindfulness-Based Stress Reduction and Sense of Coherence Among Women With Fibromyalgia

Sense of Coherence (SOC) is conceptualized as a disposition to experience life as meaningful and manageable. Research suggests a protective effect of SOC on psychological health in stressful circumstances. This study assessed the capacity of SOC to buffer the effect of illness symptoms on psychological distress among patients with fibromyalgia. Self-reported changes in SOC after participation in a Mindfulness-Based Stress Reduction (MBSR) program were also examined. Ninety-one women with fibromyalgia provided baseline data pertaining to illness symptoms, perceived stress, and depression prior to participation in a randomized trial of MBSR. SOC and fibromyalgia symptoms were independently related to perceived stress and depression at baseline. SOC was not a statistically significant moderator of symptom effects on psychological distress. In comparison with wait-listed controls, program participants reported a significant increase in SOC after MBSR participation. These results provide the first demonstration from a randomized trial that SOC may be enhanced via intervention.

Childhood trauma and diurnal cortisol disruption in fibromyalgia syndrome

Adults with fibromyalgia syndrome report high rates of childhood trauma. Neuroendocrine abnormalities have also been noted in this population. Exploratory analyses tested relationships between retrospective reports of childhood trauma and diurnal salivary cortisol patterns among 85 women with fibromyalgia. Subjects with fibromyalgia completed self-reports of childhood physical, sexual and emotional abuse, as well as emotional and physical neglect. Recent major life events, current perceptions of stress, and depressive symptoms were also assessed. Salivary cortisol was collected six times per day for two consecutive days to assess diurnal rhythm, awakening response and mean cortisol levels. Hierarchical regression analyses were performed, controlling for age, relevant medications, life events, perceived stress, and depressive symptoms. Childhood physical abuse predicted flattened diurnal cortisol rhythms as well as greater cortisol responses to awakening. Sexual abuse was a second predictor of increased awakening cortisol responses. Patients with a history of trauma had markedly low levels of cortisol at the time of first awakening, partly explaining the results. These findings suggest that severe traumatic experiences in childhood may be a factor of adult neuroendocrine dysregulation among fibromyalgia sufferers. Trauma history should be evaluated and psychosocial intervention may be indicated as a component of treatment for fibromyalgia.

Psychological Health in Cancer Survivors

OBJECTIVES The prevalence of both negative (distress) and positive responses (growth, well-being) to the cancer experience is examined and difficulties in establishing the prevalence of these responses discussed. A conceptual framework for understanding factors associated with psychological health in cancer survivors is presented. Finally, strategies for promoting psychological health in cancer survivors are examined. DATA SOURCES Review of the literature. CONCLUSION Psychological health in cancer survivors is defined by the presence or absence of distress as well as the presence or absence of positive well-being and psychological growth. Furthermore, psychological health in cancer survivors is determined by the balance between two classes of factors: the stress and burden posed by the cancer experience and the resources available for coping with this stress and burden. IMPLICATIONS FOR NURSING PRACTICE In general, promotion of psychological health is based on the prevention or treatment of distress as well as the encouragement of growth and well-being. Periodic screening for psychological distress across the cancer trajectory is critical to appropriate management of distress.

Adult rat forelimb dysfunction after dorsal cervical spinal cord injury.

Repairing upper extremity function would significantly enhance the quality of life for persons with cervical spinal cord injury (SCI). Repair strategy development requires investigations of the deficits and the spontaneous recovery that occurs when cervical spinal cord axonal pathways are damaged. The present study revealed that both anatomically and electrophysiologically complete myelotomies of the C4 spinal cord dorsal columns significantly increased the adult rats averaged times to first attend to adhesive stickers placed on the palms of their forepaws at 1 week. Complete bilateral myelotomies of the dorsal funiculi and dorsal hemisection, but not bilateral dorsolateral funiculi injuries, also similarly increased these times at 1 week. These data extend a previous finding by showing that a forepaw tactile sensory deficit that occurred in the adult rat after bilateral C4 spinal cord dorsal funiculi injury is due to damage of the dorsal columns. Averaged times to first attend to the stickers also decreased to those of sham-operated rats at 3 and 4 weeks post-dorsal hemisection with weekly testing. In contrast, a separate group of rats with dorsal hemisections had significantly increased times when tested only at 4 weeks. These data indicate that frequent assessment of this particular behavior in rats with dorsal hemisections extinguishes it and/or engenders a learned response in the absence of sensory axons in the dorsal columns and dorsolateral funiculi. This finding contrasted with weekly testing of grid walking where increased forelimb footfall numbers persisted for 4 weeks post-dorsal hemisection.

Mindfulness meditation alleviates fibromyalgia symptoms in women: results of a randomized clinical trial.

BackgroundSeveral recent reviews have evaluated evidence on the efficacy of Mindfulness-Based Stress Reduction (MBSR) among fibromyalgia sufferers, and concluded that more research should test effects on both psychological and physiological functioning.PurposeWe conducted a randomized prospective trial of MBSR among female fibromyalgia patients.MethodsEffects on perceived stress, pain, sleep quality, fatigue, symptom severity, and salivary cortisol were tested in treatment (n = 51) versus wait-list control participants (n = 40) using data at baseline, post-program, and 2-month follow-up.ResultsAnalyses revealed that MBSR significantly reduced perceived stress, sleep disturbance, and symptom severity, with gains maintained at follow-up. Greater home practice at follow-up was associated with reduced symptom severity. MBSR did not significantly alter pain, physical functioning, or cortisol profiles.ConclusionMBSR ameliorated some of the major symptoms of fibromyalgia and reduced subjective illness burden. Further exploration of MBSR effects on physiological stress responses is warranted. These results support use of MBSR as a complementary treatment for women with fibromyalgia (ISRCTN: 34628811).

Depression may mediate the relationship between sense of coherence and quality of life in lung cancer patients.

Lung cancer patients generally experience high levels of physical and psychological distress and decreased quality of life (QOL). Sense of coherence (SOC) has been conceptualized as a personality orientation reflecting the degree to which an individual perceives their world as comprehensible, manageable and meaningful. The present study investigated the associations of SOC with QOL in lung cancer. It also examined potential psychological mediators by which SOC may exert its influences on QOL. Fifty-six participants with non-small cell lung cancer were administered self-report assessments of SOC, QOL and psychological distress. Results revealed that SOC was positively associated with QOL and this relationship may be mediated by depressive symptoms. The current study supports the notion that SOC may be a protective factor with regard to psychological adjustment and QOL in cancer survivors.

Receipt of a False Positive Test Result During Routine Screening for Ovarian Cancer: A Teachable Moment?

The term “teachable moment” (TM) has been used to describe a life transition or event which motivates an individual to change a behavior or presents an opportunity to intervene to prompt behavior change. We examined whether receipt of a false positive ovarian cancer (OC) screening result may represent a TM. 403 women participating in an OC screening program completed questionnaires assessing demographic, clinical, behavioral, and psychosocial information. The TM was operationalized as expressed interest in receiving health-related information. We hypothesized that among women receiving a false positive screening test result, those women who had experienced greater personal perceived risk for OC as well as distress would be more interested in receiving health-related information than women receiving a normal result. Analyses revealed that women receiving a false positive screening result were less interested in receiving health-related information than women receiving a normal screening result. For women receiving a false positive result, expressed interest in receipt of health-related information was only modestly related to distress and related even less to perceptions of OC risk. Our data do not support viewing a false positive OC screening result as a TM. Potential explanations for the current findings as well as recommendations for future research investigating the TM are discussed.