Gil Goldzweig

Is perceived family support a relevant variable in psychological distress? A sample of prostate and breast cancer couples.

OBJECTIVE In this cross-sectional pilot study of couples in whom the man was diagnosed with prostate cancer or the woman with breast cancer, the purpose was to identify and compare the variables that characterize couples where both spouses are in high psychological distress with couples where the psychological distress of both spouses is within the normal range. METHODS Psychological distress and perception of family support in 574 individuals (118 consecutive prostate cancer patients and their spouses, and 169 randomly selected breast cancer patients and their spouses) were assessed using the Brief Symptom Inventory (BSI) and the Perceived Family Support (PFS) self-report questionnaires. RESULTS Couples experiencing high psychological distress reported lower levels of perceived family support than couples in whom both spouses reported normal levels of psychological distress. CONCLUSION The findings support the notion that perceived family support is associated with the psychological distress in both patients and spouses.

Women with advanced breast cancer and their spouses: diversity of support and psychological distress.

Objective: The current study examines the effect of perceived support from different agents (spouse, family, friends, religion—spirituality) on psychological distress experienced by women with advanced breast cancer and their male spouses.

Effects of age on coping and psychological distress in women diagnosed with breast cancer: review of literature and analysis of two different geographical settings.

Age-related differences in emotional distress were examined by studying two random samples (N=424) of women diagnosed with early stages of breast cancer in Graz, Austria and Jerusalem, Israel. We found that psychological distress, coping abilities, and different perceptions of illness are attributable to socialization differences of age experience according to young (49 or younger), intermediate (50-64) and old (65 and older) age groups. Patients were interviewed at home to obtain sociodemographic and medical background data. They also completed five standardized instruments (Brief Symptom Inventory, Psychological Adjustment to Illness Scale, Impact of Events Scale, Mental Adjustment to Cancer, and Perceived Family Support). A two-way MANOVA for all the demographic variables yielded significant main group (Graz vs. Jerusalem) effect (P<0.0001), significant main age effect (P<0.0001) and significant interaction (group by age) effect (P<0.001). Examination of the contribution of the age category to the level of the coping variables showed a different pattern in each group. The psychological distress variables revealed that, in the Jerusalem sample, there is a tendency toward decreasing distress levels with age and, in the Graz sample, elevated scores for the intermediate-age group. Age was found to be related to the level of Global Severity Index (GSI) and to the variables correlated to the GSI level. Psychological intervention should be guided to the different age groups.

How relevant is marital status and gender variables in coping with colorectal cancer? A sample of middle-aged and older cancer survivors.

Objective: While the population in the western world is aging and cancer survival rates are increasing, there is a lack of knowledge concerning factors affecting social support and its relation to coping and distress among older patients. The aim of the current study is to assess the impact of marital status and gender upon levels of psychological distress, coping, and social support among middle‐aged and older unmarried (divorced/widowed) and married colorectal cancer patients.

Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: An unexpected outcome

The population in the western world has been aging while the cancer survival rates have been systematically increasing. Knowledge is lacking about psychological processes and effects of gender difference among middle-aged cancer patients and their healthy spouses. This study assesses psychological distress, coping and social support among middle-aged couples, where one of the partners was diagnosed with colon cancer. A repeated-measure MANOVA and Pearsons correlation coefficient were used to assess the relationships between the variables. Levels of social support were found to be negatively correlated to levels of psychological distress among all of the participants. Surprisingly, men (healthy or sick) were found to be more distressed than their wives (p<0.0001). Men also reported receiving more support from their wives than did the female spouses (p<0.0005). The gender differences found in our study imply that men (healthy or sick) tend to receive more support than they give to their wives. It also implies that men do not use the support they receive as effectively as their wives. Thus, although men report higher levels of support from their spouses, they also report higher levels of psychological distress. Practical implications are discussed.

Attitudes Toward Attention-Deficit Hyperactivity Disorder (ADHD) Treatment: Parents' and Children's Perspectives

Attitudes toward pharmacological treatment may be a major factor contributing to adherence to such treatment. In the current study, attitudes toward methylphenidate treatment among 50 children diagnosed with attention-deficit hyperactivity disorder (ADHD) and their parents were assessed. Authors of this study have found that the study population is concerned and suspicious toward methylphenidate treatment. Most participants were exposed to negative information even before treatment initiation, which caused many participants to consult other sources and postpone the treatment initiation. Although experiencing methylphenidate as safe and effective (after 23.5 months of treatment), the leading cause of negative attitudes is the concern regarding long-term effects. The single most effective factor regarding the attitude toward methylphenidate treatment is the neurologists explanation. It is concluded that the pediatric neurologist has a crucial role in affecting attitudes of children and parents toward methylphenidate treatment.

Neurodevelopmental and psychological assessment of adolescents born to drug-addicted parents: effects of SES and adoption.

OBJECTIVES Prenatal exposure to heroin may have long-term consequences for development during early and middle childhood. The present research studied the cognitive, social, and emotional functioning of adolescents exposed to drugs prenatally, and investigated the extent to which the early adoption of children exposed prenatally to drugs would alleviate the possible effects of exposure. METHODS The study included 191 adolescents (12-16 years of age) and their parents in Israel, who had or had not been exposed prenatally to drugs and differing in socio-economic status (SES), and in adoptive status. They were administered five subtests of the Wechsler Intelligence Scale for Children (WISC-III), and the Youth Self-Report Form for assessing behavior problems that measures problems associated with attention deficit, self-esteem and risk-taking. Parents were administered the Child Behavior Checklist (CBCL) for assessing behavior problems, the Conners Rating Scale (CRS) for assessing attention deficit problems in their children and the Wender Utah Rating Scale (WURS), a self-report measure of ADHD-related problems. RESULTS Adolescents exposed to at least one risk factor (exposure to drugs, low SES, or adoption) performed more poorly than those exposed to none of these risk factors on the WISC-III subtests, the CBCL and the CRS. The effects of risk factors did not cumulate. Contrary to our hypothesis, adoption did not mitigate the effects of prenatal exposure to drugs: for cognitive functioning exposure to drugs was associated with poorer performance among the exposed High SES Adopted versus non-exposed High SES non-adopted children on three of the WISC-III subtests. Exposed low SES children living with their parents performed at the same relatively low level as non-exposed low SES controls. Exposure to drugs was associated with adult ADHD-related problems assessed by the WURS. There were no direct or interaction effects of exposure on neurological functioning, self-competence, behavior problems on the CBCL or risk-taking. CONCLUSIONS Children exposed to drugs of abuse prenatally, including those adopted away, and children who grow up in low SES backgrounds, may be at risk of relatively reduced cognitive functioning (though still within the normal range) in adolescence. Children exposed to drugs, who are from low SES backgrounds, or who are adopted, may be at risk for lower cognitive or social functioning than children who have not experienced such risks. PRACTICE IMPLICATIONS There is a need for implementing early monitoring and long-term intervention programs featuring encouragement of cognitive and social skills for children prenatally exposed to drugs in order to alleviate the possible long-term effects of exposure to risk.

Meeting Expectations of Patients With Cancer: Relationship Between Patient Satisfaction, Depression, and Coping

PURPOSE This study assessed satisfaction of patients with cancer and the correlation between patient levels of satisfaction and the sociodemographic, medical, and psychological variables. Satisfaction measures were based on patient expectations for emotional and cognitive support by the oncologists. PATIENTS AND METHODS A total of 1,027 patients with cancer were recruited from the outpatient departments and daycare treatment centers of four oncology institutes in Israel. Patient levels of expectations and satisfaction were assessed by using measures developed for this study. Patient psychological variables were assessed by using the Brief Symptoms Inventory, Impact of Events Scale, and Mental Adjustment to Cancer. chi(2) and Student t tests were used to assess differences between the highly satisfied group and the less satisfied group. RESULTS Lower values of satisfaction were reported on the dimensions that included the patient in the treatment plan and that included explanations to the family. Higher percentages of women, single patients, younger patients, and patients in stages II to III were found in the less satisfied group. This group reported significantly higher levels of psychological distress, anxious preoccupation, and helplessness and lower levels of fighting spirit. CONCLUSION Given the importance of patient satisfaction to treatment compliance, oncologists should consider evaluating patient expectations for support, especially in issues concerning planning the treatment and involving the family in medical decisions. Oncologists should take into account the possible interdependence between psychological variables and medical-care satisfaction.

Breast cancer and psychological distress: mothers’ and daughters’ traumatic experiences

Goal of workThe objective of this exploratory retrospective study was to assess the effects of breast cancer diagnosis upon the psychological distress of adult breast cancer patients and their mothers, particularly mothers who experienced past trauma.Materials and methodsFour groups of mother–daughter dyads were evaluated using self-reporting measures of psychological distress [Brief Symptom Inventory (BSI)], familial support (PFS), and adjustment to cancer (MAC, IES): breast cancer patients whose mothers were Holocaust survivors (group 1), breast cancer patients with non-traumatized mothers (group 2), healthy daughters of Holocaust survivor mothers (group 3), and a control group of healthy daughters with non-traumatized mothers (group 4).Main resultsDistress levels of both mothers and daughters in group 1 were significantly higher than distress levels of mothers and daughters in the other three groups. Daughters’ distress levels in all four groups were found to be significantly related to mothers’ distress levels, with the highest correlation found in both groups of cancer patients. The factors of having a clinically distressed mother and being a second-generation daughter contributed the most to predicting the clinical distress of the daughter.ConclusionsThe outcomes imply that the mother’s traumatic past intensifies the distressing effect of cancer diagnosis upon both the patient and her mother. The findings concerning the impact of cancer diagnosis upon the patients’ non-traumatized mothers were more ambiguous. The results support the idea that in the case of breast cancer patients, a complete psychological evaluation must include not only spouses and children but also the familial background of the patient and the history of the patients’ mothers.

Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire

Objective: The current study presents the development and the evaluation of the psychometric properties of the Cancer Perceived Agents of Social Support (CPASS). The CPASS is a new self‐rating instrument devised in order to enable both cancer patients and their spouses to report on the level of perceived social support they get. The CPASS evaluates the support given by different agents of support (spouse, family, friends and spiritual or religious beliefs) in several dimensions (emotional, cognitive and instrumental).