Bina Nausheen

Social support and cancer progression: A systematic review

OBJECTIVE The variability in the conceptualization and categorization of social support has resulted in mixed findings regarding its role in cancer progression. This systematic review identifies and summarizes the evidence for the significance of two important indices of social support in progression of different cancers. METHOD We used systematic and replicable methods to search, select, and evaluate findings. RESULTS Thirty-one longitudinal prospective findings (in 26 papers) which were selected for inclusion categorized social support into structural and functional support. The types of cancer included in these studies fell into three major categories: breast cancer (16), other cancer (10), and mixed cancers (5). Results suggest that the evidence for the relationship between social support and cancer progression is sufficiently strong for breast cancer as shown by five out of seven methodologically sound studies but consistently unconvincing for other types of cancer or in studies which combined different types of cancer. Structural support indices were found to be more frequently associated with disease progression than the indices of functional support in breast cancer. Disease-related variables such as severity, treatment, nodal status, and site of metastasis were found to be significant predictors of cancer progression, and it is suggested that these variables must be considered when conducting studies on the role of psychosocial factors in cancer-related outcomes including progression. CONCLUSION Methodological limitations of the studies and counterintuitive findings are discussed, and further conclusive research, particularly randomized controlled trials of social support interventions, is warranted to support the findings of this systematic review.

Loneliness, social support and cardiovascular reactivity to laboratory stress

Self-reported or explicit loneliness and social support have been inconsistently associated with cardiovascular reactivity (CVR) to stress. The present study aimed to adapt an implicit measure of loneliness, and use it alongside the measures of explicit loneliness and social support, to investigate their correlations with CVR to laboratory stress. Twenty-five female volunteers aged between 18 and 39 years completed self-reported measures of loneliness and social support, and an Implicit Association Test (IAT) of loneliness. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) reactivity indices were measured in response to psychosocial stress induced in the laboratory. Functional support indices of social support were significantly correlated with CVR reactivity to stress. Interestingly, implicit, but not explicit, loneliness was significantly correlated with DBP reactivity after one of the stressors. No associations were found between structural support and CVR indices. Results are discussed in terms of validity of implicit versus explicit measures and possible factors that affect physiological outcomes.

Relationship Between Loneliness and Proangiogenic Cytokines in Newly Diagnosed Tumors of Colon and Rectum

Objective: To investigate the association of serum levels of proangiogenic cytokines with different indices of social support and loneliness by measuring the levels of expression of two important proangiogenic cytokines, vascular endothelial growth factor (VEGF), and interleukin-6 in tumors of colon and rectum. Lack of social support has been prospectively associated with cancer progression. Methods: Fifty-one newly diagnosed patients with colorectal tumors (mean age, 68.3 years) completed two measures of loneliness 1 to 2 days before their surgical treatment. The first was an explicit self-report questionnaire, which tapped into negative feelings as a result of low social support. The second was a standardized computer-based task, which measured loneliness implicitly. Immunohistochemical analyses were performed on tumor tissues post surgery to determine the expression of cytokines. Results: Logistic regression showed that higher levels of implicit loneliness independently predicted stronger expression of VEGF, controlling for Dukes stage and explicit loneliness, both of which were nonsignificant predictors. No significant relationships were found between the loneliness measures and interleukin-6. Conclusions: The results of this study suggest VEGF to be an angiogenic mechanism through which loneliness may lead to worse cancer-related outcomes. Implications are discussed in terms of devising targeted psychosocial and immunotherapeutic interventions for cancer patients with low social support. ACTH = adrenocorticotropin hormone; CRF = corticotrophin releasing factor; DAB = diaminobenzidine; IL = interleukin; SNS = sympathetic nervous system; VEGF = vascular endothelial growth factor.

High-yield cognitive behavioral techniques for psychosis delivered by case managers to their clients with persistent psychotic symptoms: an exploratory trial.

Abstract Case managers spend more time with clients with schizophrenia than any other professional group does in most clinical settings in the United States. Cognitive behavioral therapy (CBT) adapted for individuals with persistent psychotic symptoms, referred to as CBT-p, has proven to be a useful intervention when given by expert therapists in randomized clinical trials. It is currently unknown whether techniques derived from CBT-p could be safely and effectively delivered by case managers in community mental health agencies. Thirteen case managers at a community mental health center took part in a 5-day training course and had weekly supervision. In an open trial, 38 clients with schizophrenia had 12 meetings with their case managers during which high-yield cognitive behavioral techniques for psychosis (HYCBt-p) were used. The primary outcome measure was overall symptom burden as measured by the Comprehensive Psychopathological Rating Scale, which was independently administered at baseline and end of intervention. Secondary outcomes were dimensions of hallucinations and delusions, negative symptoms, depression, anxiety, social functioning, and self-rated recovery. Good and poor clinical outcomes were defined a priori as a 25% improvement or deterioration. t-Tests and Wilcoxon’s signed-ranks tests showed significant improvements in all primary and secondary outcomes by the end of the intervention except for delusions, social functioning, and self-rated recovery. Cohen’s d effect sizes were medium to large for overall symptoms (d = 1.60; 95% confidence interval [CI], −2.29 to 5.07), depression (d = 1.12; 95% CI, −0.35 to 1.73), and negative symptoms (d = 0.87; 95% CI, −0.02 to 1.62). There was a weak effect on dimensions of hallucinations but not delusions. Twenty-three (60.5%) of 38 patients had a good clinical result. One (2.6%) of 38 patients had a poor clinical result. No patients dropped out. This exploratory trial provides evidence supportive of the safety and the benefits of case managers being trained to provide HYCBt-p to their clients with persistent psychosis. The benefits reported here are particularly pertinent to the domains of overall symptom burden, depression, and negative symptoms and implementation of recovery-focused services.

Attentional biases in clinical populations with alcohol use disorders: is co-morbidity ignored?

To identify how psychiatric co‐morbidity was identified and assessed, in studies of attentional bias in clinical samples of patients with alcohol use disorders (AUDs).

Movement disorders in patients with schizophrenia and a history of substance abuse

The movement disorders acute dystonia, akathisia, Parkinsonian symptoms and tardive dyskinesia [extrapyramidal side effects (EPSs)] are recognized adverse effects of antipsychotic medication. Previous studies have indicated that substance abuse in patients with schizophrenia can worsen EPS. This study therefore investigated the relationship between drug and alcohol use and EPS in a group of patients with schizophrenia.

Shift resources and focus from psychiatric beds to the community

Tyrer’s case for a moratorium on or even an increase in the number of psychiatric beds seems to be primarily based on the current poor care in units, lack of continuity, and increased risks to service users.1 However, as Johnson says,2 the evidence that risk …

Implicit versus explicit loneliness: which best correlates with cardiovascular reactivity to stress?

In alphabetical order by first author Are perceptions of future health risks included in the global health assessment? Aalto, A.-M.; STAKES, Finland Objective Do perceived risk of myocardial infarction (PRMI) and severity of coronary heart disease (CHD) predict global self-rating of health (SRH)? Methods A postal survey of 2745 people with diagnosed CHD. PRMI was measured by absolute personal risk; severity was assessed by self-rate NYHA. Results Adjusting for baseline SRH, socio-demographic factors, other illnesses, and life-style factors, poor SRH 1 year later was predicted by baseline CHD severity, presence of CHD risk factors and higher PRMI. Conclusions In addition to present health, SRH also reflects assessments of potential future risks, which may partly account for the good predictive value of SRH. The effects of a relaxation training programme for elementary school children Abe, M.* & Mori, K.; *Obirin University, Japan Objective This study investigated the effectiveness of both progressive muscle relaxation and deep-breathing relaxation for fifth and sixth graders. Methods Sixty-six children aged 11–12 years participated in this study. The two types of relaxation sessions were held four times a week in alternate weeks for 1 month. Two-Dimensional Mood Scale (TDMS) was measured before and after each session. Results The children’s mood improved after the second session of progressive muscle relaxation. However, the deep-breathing relaxation made their mood better after just the first session. Conclusion The deep-breathing relaxation was an effective method to improve the children’s moods. Applying health psychology theories and models in disease prevention: Two examples Absetz, P.*, Valve, R., & Heinonen, H.; *National Public Health Institute, Finland Objectives This paper discusses the use of health psychology theories and models in two interventions: a lifestyle counselling program to prevent type II diabetes among middle-aged adults, and a physical activity program to promote functional capability among older adults. ISSN 0887-0446 print/ISSN 1476-8321 online/06/S10009–169 2006 Taylor & Francis DOI: 10.1080/14768320600901313 Methods Participants in the lifestyle counselling are at-risk clients in the primary health care centres. Intervention components are based on HAPA model and Self-regulation theories. Participants in the physical activity program are home care clients over 70 years of age. Intervention components are based on self-determination and self-regulation theories of behaviour change and broaden-and-build theory of positive emotions. Measures include instruments for the theoretical constructs, health behaviour, clinical risk factors, functional capability and health. Results Examples will be given of how the theoretical constructs translate into practical intervention strategies, helping to target the interventions according to objectives and participants. Burnout among Hungarian female and male physicians: prevalence and potential precursors Adam, S.* & Gyorffy, S.; *Semmelweis University, Hungary Objective To explore the prevalence and potential precursors of burnout among Hungarian physicians. Methods Cross-sectional survey among 211 female and 203 male physicians. The Maslach Burnout Inventory was used to identify physicians with high levels of burnout (high scores on the emotional exhaustion or depersonalisation subscales). Results Significantly more female than male physicians experienced high levels of burnout (46 vs. 35%; P1⁄4 0.02). Work-family conflict (WFC) emerged as a significant precursor of burnout among physicians. Conclusion These findings are the first to show associations between WFC and burnout among scarcely researched female and male physicians in a unique cultural setting and provide further data for cross-cultural burnout research. Narratives and disease significations in children with type 1 diabetes mellitus Aguiar, S.* & Fonte, C.; *Fernando Pessoa University, Portugal Objective The aim of this study is to understand and explore the disease experience perceived by children with type 1 diabetes mellitus, oriented by the narrative model. Methods Grounded Theory was used as a methodological framework. Data were collected by semi-structured interview. Ten children, equally shared by gender, with the age range from 7 to 12 years old, compose sampling. Results Results showed the magnitude of disease experience in children’s daily life and could be explained by developmental peculiarities. Conclusion This study demonstrated that treatment of diabetes in children must take into account these narratives and reinforce the psychologist role in this field. The relationship between expectancies and interpersonal differences in self-control performance Alberts, H. J. E. M.*, Martijn, C., & de Vries, N. K.; *University Maastricht, The Netherlands Objective The ‘limit energy model’ states that self-control failure occurs because acts of self-control draw on a limited resource of energy. We tested if it matters whether people think that self-control is dependent on (limited) energy. 10 Abstracts