Atara Kaplan De-Nour

Prospective study of cancer patients and their spouses: the weakness of marital strength.

In a prospective study, 133 married cancer patients and their spouses were interviewed within a month of diagnosis and administered three self‐reports: The Brief Symptom Inventory (BSI) to assess psychological distress, the Impact of Events Scale (IES) to assess coping, and the Family Adaptability and Cohesion Scales (FACES III) to assess family relations.

CANCER IN MARRIED COUPLES: HIGHER OR LOWER DISTRESS?

This study focuses on the question of what occurs when both spouses become seriously ill. Our hypothesis was that psychological distress in married couples involving two ill partners is far higher than when only one partner is ill. The study group comprised 20 married couples, in which both spouses were diagnosed with cancer. Two comparison groups were also studied: 20 married couples with the husband diagnosed with cancer, and 20 couples with the wife diagnosed with cancer. All patients in the three groups completed four self-report scales: the Brief Symptom Inventory (BSI); the Perceived Family Support (PFS); the Impact of Events Scale (IES); and the Mental Adjustment to Cancer (MAC). The healthy spouses completed only the first three scales. Our findings supported the null hypothesis--that is, that the psychological distress in married couples with both partners diagnosed with cancer was not significantly different than when only one partner had cancer. Our findings also showed that neither sociodemographic background, medical condition, nor family support affect patient distress. Gender differences were found with Intrusiveness contributing to the distress of male, but not female, patients. This study confirms and augments earlier work, and shows that partners of cancer patients report a high degree of distress, with this level of distress not being much different from that of the patients.

Psychological distress in healthy women with familial breast cancer: like mother, like daughter?

Objective: In 1977, the Israel Cancer Association held a one-day conference, on the subject of familial breast cancer, for healthy women with at least one first-degree relative diagnosed with breast cancer. The objective of this study was to assess the psychological distress of a sample of the women who attended. Method: Of the 333 healthy women present at the conference, 230 completed three questionnaires: one on sociodemographic data and the medical history of the first-degree relative(s) (mother and/or sister), and two that measure psychological distress: the Brief Symptom Inventory and the Impact of Events Scale. Sample: The subjects were divided into three categorical groups: those whose mother had breast cancer (group A, N = 176), those whose sister had breast cancer (group B, N = 34), and those whose mother and sister both had the disease (group C, N = 20). In addition, subjects were divided into two groups according to the psychological distress level. Results: Analysis of results (using ANOVA and a Chi square test for categorical variables and both univariate and multivariate procedures for psychological distress assessment) showed elevated levels of distress and persistent intrusive thoughts in all groups, and particularly in group C. Conclusion: There is a need to promote genetic diagnostic and appropriate counseling, notwithstanding the potential risks that genetic counseling poses for such women.

The Role of Psychological Variables in a Group of Melanoma Patients:An Israeli Sample

This study examined whether there is a difference in the psychological distress and/or coping modes of patients with early localized malignant melanoma. The authors compared the patients diagnosed at stages IA and B of the disease with those diagnosed at stages IIA and B. The population consisted of 100 melanoma patients who agreed to take part in a study of adjustment to chronic disease. The patients were individually interviewed at home and completed six self-reports. Three of the reports assessed psychological outcome, two assessed coping, and one assessed support systems. No substantial differences were found between the patients treated at stages I and II on any of the psychological measures, despite the fact that those with greatest thickness and depth (stage IIB) are at higher risk of recurrence. The women showed greater distress than the men, confirming earlier observations made in patients with colon cancer.

Holocaust Cancer Patients: A Comparative Study

There is as yet no consensus on the long-term effects of severe life-threatening stresses. In an earlier study (Baider et al. 1992), we gained some understanding of this issue by addressing a specific question: How do individuals who have undergone severe stress in the past cope with a current stress? We investigated whether severe stress occurring in the past had a long-term effect on present coping capabilities. We addressed the question by studying a group of Holocaust survivors (severe past stress) who were diagnosed as having cancer (current stress) and compared them to a matched group of cancer patients with no past history of trauma. The matching was done on most demographic variables (gender, age, marital status, and education), as well as on disease variables (site and stage of cancer, time since cancer diagnosis, previous and present treatments). The results were unequivocal.

Coping with additional stresses : Comparative study of healthy and cancer patient new immigrants

The adjustment and psychological distress of 166 cancer patients, who are new immigrants from the former Soviet Union, was assessed and compared to that of 288 healthy new immigrants from the the former Soviet Union. The healthy new immigrants had many adjustment problems and their psychological distress was fairly high. The cancer patients reported extremely severe psychological distress. In the healthy immigrants, age contributed to distress while family support had significant protective effects especially in the male immigrants. In the patients, these differences were even more extreme with family support being protective in the male group but not in the female group. Intrusiveness (IES) seems to be maladaptive adding to distress. The results clearly indicate that additional stresses, such as immigration, make cancer patients more vulnerable. The results also suggest possible interventions, especially those that will help to decrease intrusiveness.

Coping Behavior and Intelligence in the Prediction of Vocational Rehabilitation of Dialysis Patients

As part of an intensive psychiatric and psychological examination before starting hemodialysis, forty-seven patients with terminal renal failure, thirty-one men and sixteen women with an age range from the late teens to the mid fifties, had been administered with WBII and the Shanan Sentence Completion technique. The hypothesis was that coping style would predict adaptation to hemodialysis as assessed by vocational rehabilitation. Intelligence, level of education, and the tendency to perceive sources of conflict in the outer world rather than within oneself, were found predictive of subsequent adaptations for the whole group. On all these variables, men and women showed different patterns of significant correlations between the different aspects of coping and vocational rehabilitation. Subsequent multiple step-wise regression showed women (percentage of explained variance: 75) to be more predictable than men (40%) with different variables contributing differentially to predictability. These findings, interpreted to support the general working hypothesis, are discussed in terms of their implications for treatment.

Crossing new bridges: the process of adaptation and psychological distress of Russian immigrants in Israel.

Between the end of 1989 and June 1992, 380,152 Russian Jews left the former Soviet Union for Israel, swelling Israels Jewish population by nearly 10%. Absorbing great waves of immigrants was not new to Israel. Since its establishment in 1948 and the enactment of its Law of Return, large population groups from dozens of different ethnic and cultural backgrounds had immigrated into the country. In 1992 Israels Jewish population totaled 4,242,500. Of that number, 360,949 had been born in Asian countries, 458,009 in Africa, 1,252,131 in Europe, and 184,317 in America and Oceana.

Childhood imaginary companionship and mental health in adolescence

An imaginary companion (IC) is a frequently encountered childhood fantasy, invisible to anyone but the child, who may be named, addressed or played with. Whether the presence of an IC is a normal developmental feature has not been determined. We examined psychometric measures and the presence/absence of childhood IC in a sample of 850 mentally healthy adolescents. 17.6% of our subjects, more often females, reported having had such a companion. Subjects who reported having had an IC in childhood exhibited higher levels of distress and emotional discontrol, displayed prolonged transitional object attachment and immature modes of coping with stress. Thus, although childhood imaginary companionship is not indicative of psychopathology, it may denote a vulnerability for adolescent perturbation and difficulty in coping with emotionally laden situations.

Psychological well-being and ratings of psychiatric symptoms in bereaved Israeli adolescents: differential effect of war-versus accident-related bereavement.

Eight hundred seventy-one Israeli adolescents, 375 boys and 496 girls, mean age 16.7 +/- 1, participated in this study. Twenty-three of them lost relatives in war and 19 in road accidents. All participants were administered the Brief Symptom Inventory (BSI), the General Well-being Scale (GWB), the Parental Bonding Instrument (PBI) and the Perceived Social Support-Family/Friend (PSS-Fa and PSS-Fr) measures. War-bereaved adolescents showed significantly higher scores in psychological well-being (GWB) and significantly lower scores in reported psychiatric symptoms (BSI) than accident-bereaved adolescents. War-bereaved adolescents also had significantly better BSI and GWB scores than the general nonbereaved adolescent population. These results persisted after controlling for family socio-economic status, gender, and the degrees of closeness of the deceased relative. War-bereaved adolescents did not differ either from accident-bereaved adolescents or from the nonbereaved general adolescent population in social and family support systems (PSS-Fr, PSS-Fa) and did not experience different basic parental attitudes (PBI). Results are discussed in terms of the different meanings ascribed to death in battle versus death in a road accident.