Shelly L. Curran

Short Form of the Profile of Mood States (POMS-SF): Psychometric information.

The Profile of Mood States (POMS; P. M. McNair, M. Lorr, & L. F. Droppleman, 1981) is a commonly used measure of psychological distress. The length of this scale (65 items) may limit its use with physically ill or otherwise impaired populations or prevent its inclusion in multiinstrument assessment protocols. This study evaluated the psychometric properties of a shorter, 37-item version of the POMS developed by S. Shacham (1983; POMS-SF). Data were provided by 600 respondents representing five different clinical samples and one sample of healthy adults. For all samples, internal consistency estimates for the POMS-SF subscales were very comparable to those for the original POMS. Furthermore, correlations between total mood disturbance and subscale scores on the POMS-SF and those from the original POMS all exceeded .95. The POMS-SF is considered an excellent alternative to the original POMS when a brief measure of psychological distress is desired.

Off-treatment fatigue in breast cancer survivors : A controlled comparison

Fatigue is a common and distressing symptom following cancer treatment. Research examining “off-treatment” fatigue has been weakened by limited assessments of fatigue and lack of suitable comparison groups. The extent of off-treatment fatigue following treatment for breast cancer (BC) was examined. Women with BC (n = 88; mean, 28 months posttreatment) and age-matched women (n = 88) with benign breast problems (BBP), completed a set of fatigue questionnaires at an Initial assessment and a 4-month Follow-up assessment. The BC group reported more fatigue, more weakness, and less vitality relative to the BBP group at both assessments. No relationship was found in the BC group between fatigue and extent of treatment or time since treatment completion. While the results document the existence of off-treatment fatigue following BC, elucidation of the psychobiological processes underlying this symptom and development of clinical management strategies remain as challenges for future research.

PSYCHOSOCIAL ADJUSTMENT AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER AND BENIGN BREAST PROBLEMS: A CONTROLLED COMPARISON

Comparison of psychosocial adjustment in women with breast cancer (BC) and women with benign breast problems (BBP) has been hampered by a failure to control for age differences between these groups, as well as a failure to assess positive psychosocial adaptation in addition to psychological distress. Age-matched women with breast cancer (n = 80) and benign breast problems (n = 80) completed measures of psychological distress, positive psychosocial adaptation, and general quality of life (QOL). Breast cancer patients had completed primary treatment for breast cancer a mean of 24.6 months prior to participation (range, 6-57 months). Comparison of the BC and BBP groups indicated that the BC group reported (1) poorer physical health and functioning, (2) no differences in psychological distress, and (3) greater positive psychosocial adaptation, such as improved life outlook, enhanced interpersonal relationships, and deeper spiritual and religious satisfaction. Results support the theoretical position that cancer is a transitional event, that is, a traumatic event that alters an individuals assumptive world with the potential to produce long-lasting changes of both a positive as well as negative nature. This underscores the importance of using measures of both psychological distress and positive psychosocial adaptation when assessing psychological adjustment following transitional events such as breast cancer.

psychological and physiological parameters of masticatory muscle pain

&NA; The objective of this research was to identify the psychological and physiological variables that differentiate persons reporting masticatory muscle pain (MMP) from normal controls (NC). This study examined the characteristics of 35 MMP patients in comparison to 35 age‐, sex‐, and weight‐matched NCs. All subjects completed a series of standardized questionnaires prior to undergoing a laboratory evaluation consisting of a psychosocial stressor and pressure pain stimulation at multiple body sites. During the evaluation, subjects’ emotional and physiological responses (heart rate, blood pressure, respiration, skin temperature, and muscle activity) were monitored. Results indicated that persons with MMP reported greater fatigue, disturbed sleep, depression, anxiety, menstrual symptoms, and less self‐deception (P’s<0.05) than matched controls. At rest, MMPs had lower end tidal carbon dioxide levels (P<0.04) and lower diastolic blood pressures than the NCs (P<0.02). During laboratory challenge, both groups responded to the standard stressor with significant physiological activity and emotional responding consistent with an acute stress response (P<0.01), but there were no differences between the MMPs and NCs. Muscle pain patients reported lower pressure pain thresholds than did NCs at the right/left masseter and right temporalis sites (P’s<0.05); there were no differences in pressure pain thresholds between MMPs and NCs for the left temporalis (P<0.07) and right/left middle finger sites (P’s>0.93). These results are discussed in terms of the psychological and physiological processes that may account for the development of muscle pain in the masticatory system.

Ecological Momentary Assessment of fatigue following breast cancer treatment

Fatigue is a common and debilitating symptom often experienced during and following cancer treatment. An Ecological Momentary Assessment (EMA) approach was used to examine the diurnal pattern of off-treatment fatigue in breast cancer survivors. Twenty-five breast cancer (BC) survivors 6–26 months posttreatment and age-matched groups of healthy women (HC; n = 25) and women with benign breast problems (BBP; n = 24) completed four daily diary measures of fatigue, pain, and mood for 5 consecutive days. Type of activity engaged in at the time of the diary assessments, as well as daily pedometer activity level, and nightly sleep duration were also assessed. While BC survivors reported greater levels of fatigue relative to BBP and HC groups, no group differences in mood, activity type or level, sleep duration, or diurnal pattern of fatigue were evident. The results confirm that fatigue may continue to be experienced long after conclusion of cancer treatment while questioning its clinical significance, provide insight into potential etiological mechanisms underlying off-treatment fatigue in, and demonstrate the value of EMA approaches to the study of cancer-related fatigue.

Rheumatoid Symptoms Following Breast Cancer Treatment: A Controlled Comparison

The prevalence of rheumatoid symptoms following breast cancer (BC) treatment was examined. Breast cancer patients (n = 111) who were a mean of 27.6 months postcompletion of BC treatment and 99 otherwise healthy women with benign breast problems (BBP) completed a self-report measure that assessed current joint pain, swelling, and stiffness, as well as measures of quality of life. Results supported a hypothesized link between BC and rheumatoid symptoms: (1) the BC group was more likely to report joint stiffness lasting more than 60 min following morning waking; (2) the prevalence of unilateral or bilateral joint point or swelling was greater (P < 0.10) in the BC group for four of 10 joint-symptom combinations examined, with differences between the BC and BBP groups in upper extremity joint swelling particularly pronounced; and (3) 41% of the BC group reported that current rheumatoid symptoms exceeded those experienced prior to diagnosis. Within the BC group, the data did not support postchemotherapy rheumatism as an explanation for rheumatoid symptoms. Rather, data suggested that symptoms were associated with surgical management of BC. Finally, among women in the BC group with the most severe joint pain, only a minority were receiving medication for these symptoms. Given the relationship between rheumatoid symptoms and quality of life, more systematic research examining potential contributing factors such as menopausal status, concurrent lymphedema, and weight gain is warranted.

Stretch-Based Relaxation Training

This paper is a review of progressive relaxation training based on muscle stretching exercises. Stretch-based relaxation training is an alternative to traditional tense-release methods for teaching self-regulation of muscle activity. The rationale and basic procedures for stretch-based relaxation are presented, along with a review of research studies exploring the clinical efficacy of the techniques. Experimental evidence has demonstrated decreases in subjective measures of muscle tension and activation, as well as decreases in EMG activity at selected target muscle sites when stretch-based relaxation procedures are employed. The clinical application of stretch-based relaxation is presented and illustrated with a case study describing the use of these procedures to assist in the treatment of neck tension/pain and anxiety. Discussion centers on the potential role of stretch-based relaxation in the management of anxiety and musculoskeletal disorders.

Influence of a sympathomimetic amine on masticatory and trapezius pain/pressure thresholds and electromyographic levels

OBJECTIVES This study examined the influence of terbutaline, a beta-adrenergic sympathomimetic amine on pain/pressure thresholds in the index fingers and masseter and trapezius muscles and electromyographic activity in trapezii. STUDY DESIGN In a randomized and double-blind controlled trial, 20 asymptomatic female subjects were assigned to receive either an injection of terbutaline or sterile water before collection of pain/pressure thresholds and electromyographic levels. Repeated analysis of variance and paired t tests were calculated to test for baseline and postinjection differences between groups. RESULTS No significant baseline or postinjection group differences in pain/pressure thresholds or electromyographic were detected. CONCLUSIONS beta-adrenergic sympathomimetic stimulation does not influence pain/pressure thresholds or electromyographic activity in the masselet and trapezius muscles or pain/pressure thresholds in the index fingers. These results suggest that development of painful muscle conditions is not caused by elevations of sympathetic activity.