Kenneth I. Pakenham

Adjustment to multiple sclerosis: Application of a stress and coping model

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n = 96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS.

Altered cognitive function in men treated for prostate cancer with luteinizing hormone-releasing hormone analogues and cyproterone acetate: A randomized controlled trial

Objective  To report the first systematic investigation of the cognitive effects of luteinizing hormone‐releasing hormone (LHRH) analogues in male patients, as LHRH analogues have been associated with memory impairments in women using these drugs for gynaecological conditions.

The role of illness, resources, appraisal, and coping strategies in adjustment to HIV/AIDS: the direct and buffering effects.

This study examined the utility of a stress and coping model of adjustment to HIV/AIDS. A total of 114 HIV-infected gay or bisexual men were interviewed and they completed self-administered scales. Predictors included illness variables (disease stage and number of symptoms), coping resources (optimism and social support), appraisal (threat, challenge, and controllability), and coping strategies (problem- and emotion-focused). Adjustment outcomes were depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that better adjustment was related to an asymptomatic illness stage, fewer HIV-related symptoms, greater social support, challenge and controllability appraisals, problem-focused coping, and lower threat appraisals and reliance on emotion-focused coping. There was limited support for the stress-buffering effects of optimism. Findings support the utility of a stress and coping model of adjustment to HIV/AIDS.

Relationships Between Adjustment to HIV and Both Social Support and Coping

This study examined the relationships between HIV stage, social support, coping strategies, and adjustment to HIV. Ninety-six HIV-infected gay men and 33 seronegative comparison group participants participated in the study. In general, coping strategies and social support did not differ according to HIV stage. As predicted, adjustment was related to social support and coping strategies. Coping strategies were linked to psychosocial adjustment, whereas social support was more strongly associated with health-related variables. There was little evidence of buffering effects of either coping strategies or social support. Four coping strategies were related to low levels of psychological distress. Contrary to expectation, the relationships between coping strategies and adjustment did not vary as a function of HIV stage. However, the relationship between adjustment and some elements of social support varied as a function of HIV stage.

Adjustment in mothers of children with Asperger syndrome An application of the double ABCX model of family adjustment

The present study examined the applicability of the double ABCX model of family adjustment in explaining maternal adjustment to caring for a child diagnosed with Asperger syndrome. Forty-seven mothers completed questionnaires at a university clinic while their children were participating in an anxiety intervention. The children were aged between 10 and 12 years. Results of correlations showed that each of the model components was related to one or more domains of maternal adjustment in the direction predicted, with the exception of problem-focused coping. Hierarchical regression analyses demonstrated that, after controlling for the effects of relevant demographics, stressor severity, pile-up of demands and coping were related to adjustment. Findings indicate the utility of the double ABCX model in guiding research into parental adjustment when caring for a child with Asperger syndrome. Limitations of the study and clinical implications are discussed.

Quality of life compared during pharmacological treatments and clinical monitoring for non-localized prostate cancer: a randomized controlled trial.

To investigate the effects of different management strategies for non‐localized prostate cancer on mens quality of life and cognitive functioning.

Benefit finding in multiple sclerosis and associations with positive and negative outcomes.

This study examined the direct and stress-buffering effects of benefit finding on positive and negative outcomes. A total of 502 people with multiple sclerosis completed a questionnaire at Time 1 and, 3 months later, at Time 2 (n = 404). Measures of illness were collected at Time 1, and number of problems, stress appraisal, benefit finding, subjective health, and negative (global distress, negative affect) and positive (life satisfaction, positive affect, dyadic adjustment) outcomes were measured at Time 2. Factor analyses showed the Benefit Finding scale to have 2 dimensions: Personal Growth and Family Relations Growth. Hierarchical regressions showed that after controlling for the effects of demographics, illness, problems, and appraisal, benefit finding showed strong direct effects on the positive outcomes. Benefit finding did not have a direct effect on distress or subjective health but had a weak association with negative affect. Family Relations Growth had a stress-buffering effect on distress.

Feasibility and effectiveness of psychosocial resilience training: a pilot study of the READY program.

Despite many studies on the characteristics associated with resilience, there is little research on interventions to promote resilience in adults. The aims of this study were to gather preliminary information regarding the feasibility of implementing a group psychosocial resilience training program (REsilience and Activity for every DaY, READY) in a workplace setting, and to assess if program would potentially promote well-being. The program targets five protective factors identified from empirical evidence: Positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect core acceptance and commitment therapy (ACT) processes and cognitive behavior therapy strategies. Sessions involve psychoeducation, discussions, experiential exercises, and home assignments. Sixteen participants completed 11 × two h group sessions over 13 weeks. Baseline and post-intervention assessment included self-administered questionnaires, pedometer step counts, and physical and hematological measures. Data were analyzed using standardized mean differences and paired t-tests. There was a significant improvement between baseline and post intervention scores on measures of mastery (p = 0.001), positive emotions (p = 0.002), personal growth (p = 0.004), mindfulness (p = 0.004), acceptance (p = 0.012), stress (p = 0.013), self acceptance (p = 0.016), valued living (p = 0.022), autonomy (p = 0.032) and total cholesterol (p = 0.025). Participants rated the program and materials very highly. These results indicate that the READY program is feasible to implement as a group training program in a workplace setting to promote psychosocial well-being.

Application of a stress and coping model to caregiving in multiple sclerosis

This study examined the utility of a stress and coping model of adjustment to multiple sclerosis (MS) caregiving. A total of 89 MS caregivers and their care recipients completed self-administered scales at Time 1 and 12 months later, Time 2 (n = 51). Predictors included care recipient disability and distress, caregiver gender, social support, appraisal (threat, control and challenge) and problem-and emotion-focused coping strategies. Adjustment outcomes were Times 1 and 2 depression, global distress and caregiving impact. Almost one-third of the caregivers reported clinically significant levels of psychological distress. Results from hierarchical regression analyses on the cross-sectional data indicated that after controlling for the effects of caregiver gender, better Time 1 adjustment was related to less care recipient disability and distress, higher social support, lower threat appraisals and less reliance on emotion-focused coping and, unexpectedly, problem-focused coping. These relations were supported by correlations performed on the longitudinal data. Findings support the utility of a stress and coping model of adaptation to caregiving in MS.

Describing and predicting psychological distress after colorectal cancer

Psychological distress in cancer survivors can be detrimental to treatment adherence and self‐care tasks and is associated with poor health behaviors and decreased overall quality of life. The prevalence, course, and predictors of psychological distress after the diagnosis of colorectal cancer are to date not well described.