Michael W. Bridges

PERSON VARIABLES AND HEALTH : PERSONALITY PREDISPOSITIONS AND ACUTE PSYCHOLOGICAL STATES AS SHARED DETERMINANTS FOR DISEASE

This article reviews prospective evidence linking certain classes of person variables to multiple disease end points. Included in the review is a consideration of the effects of hostility and anger, emotional suppression, depression, fatalism, and pessimism on coronary heart disease, cancer, and acquired immunodeficiency syndrome. A model is presented that integrates several of these variables into an overall conceptual scheme. In addition, several variables are identified that appear to moderate the strength of the relationships that are found between person variables and health. The article concludes with some suggested directions for future research.

Interventions to Enhance Physical and Psychological Functioning Among Younger Women Who Are Ending Nonhormonal Adjuvant Treatment for Early-Stage Breast Cancer

PURPOSE To conduct a clinical trial to determine if an educational intervention and a nutritional intervention could enhance physical and psychological functioning among younger women completing treatment for early-stage breast cancer. PATIENTS AND METHODS Younger women (50 years of age or younger, N = 252), within 2 months of having completed active nonhormonal adjuvant therapy, diagnosed with stage 0, I, or II breast cancer with 10 or fewer positive lymph nodes were randomly assigned to a three-arm clinical trial. Women in the control arm of the trial received standard medical care. Women in the two active arms received either an educational intervention, designed to provide information about their illness and enhance adjustment, or a nutritional intervention, designed to promote a more healthy diet. Primary end points included mental functioning, physical functioning, and depressive symptoms. Women were assessed before random assignment, 4 months later (immediately post-intervention), and 13 months later (9 months post-intervention). RESULTS Participants assigned to the two active treatment arms had significantly less depressive symptomatology and better physical functioning by 13-month follow-up (differences between the two active arms were nonsignificant). These effects were primarily accounted for by changes in intrusive thoughts, concerns regarding cancer recurrence and mortality, self-concept perceptions, and self-efficacy expectations. CONCLUSION Tailored psychosocial interventions can be effectively designed to enhance adjustment among younger women who are completing nonhormonal adjuvant therapy.