Tina M. Gremore

Psychosocial Issues Confronting Young Women with Breast Cancer

The current paper reviews the literature regarding psychosocial issues confronting young women with breast cancer. The findings indicate that younger women with breast cancer experience a lower quality of life after cancer compared to older women. In part, this lower quality of life results from the effects of medical treatment. The effects of surgery and removal of the breast result in more negative feelings regarding body image, particularly for young women. With systemic treatment, many younger women experience the sudden onset of menopause, with the attendant symptoms of hot flashes, decreased sexual desire, and vaginal dryness. These physical effects along with a variety of relationship issues contribute to a high level of sexual concerns for young women. From a psychosocial perspective, breast cancer affects both females and their male partners. Both partners experience psychological distress including depression and anxiety. Within the relationship, emotional support from the partner is important in womens adjustment. In terms of psychosocial interventions for breast cancer, findings suggest that the most frequently employed interventions, which treat the woman without her partner, are not optimal. Initial findings provide encouraging evidence that couple-based psychosocial interventions for women and their partners might be of particular assistance to both partners.

A couple-based intervention for female breast cancer

Objective: Although womens breast cancer affects both women and their male partners, as well as their relationships, few interventions have been developed to work with couples confronting breast cancer. The current investigation presents the pilot results from a new couple‐based intervention program for breast cancer that teaches couples how to minimize negative effects and maximize positive functioning during this difficult time.

Psychometric Analysis of the Psychopathic Personality Inventory (PPI) With Female Inmates

This study evaluated the reliability, internal structure, and validity of the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) among female inmates (n = 153) housed at a multilevel prison facility. Findings from this research suggested both strengths and weaknesses associated with PPI psychopathy assessment. Reliability of the PPI was supported by internal consistency analyses of scale and subscale item sets, and test-retest reliability was supported by findings obtained with a subsample (n = 36) retested an average of 49 days after initial test administration. Validity of the PPI total score was also supported by moderate to very high correlations with other self-report measures of psychopathy. Relative weaknesses of the PPI were evident by the low or negative associations among many of the PPI subscales, moderate associations that PPI total scores demonstrated with response set indexes, and the similarity of PPI total scores among female inmates and undergraduates. Findings from this research are considered in relation to possible sex differences in the expression of psychopathy and challenges associated with the assessment of the psychopathy construct with self-report methods.

Quantifying the recruitment challenges with couple-based interventions for cancer: Applications to early-stage breast cancer

Objective: Despite mounting evidence supporting the use of psychosocial interventions to promote adaptation to cancer, enrolling participants into these interventions is challenging. This is particularly salient for couple‐based interventions, and newer, more targeted recruitment strategies to increase enrollment are needed. However, there have been few published empirical studies focused specifically on recruitment‐related variables associated with enrollment into these types of interventions. To better understand how to encourage participation in couple‐based psychosocial interventions for cancer, we examined facilitating and impeding factors to enrollment into a couple‐based intervention for women with early‐stage breast cancer.

Stress buffering effects of daily spousal support on women's daily emotional and physical experiences in the context of breast cancer concerns.

OBJECTIVE This study examined whether the relationship between daily spousal support and daily psychological and physical outcomes varied as a function of level of breast cancer related concern (stress buffering model). DESIGN Ninety-five women with early stage breast cancer completed daily reports of emotional and physical experiences and satisfaction with spousal support for 30 days. Women also rated problems dealing with three types of cancer specific concerns: emotional, physical, and social. MAIN OUTCOME MEASURES Womens positive and negative affect and cancer related pain and fatigue. RESULTS Multilevel analyses supported a stress buffering effect for social concerns and a reverse stress buffering effect for emotional and physical concerns. CONCLUSION Daily spousal support appears to be an important contributor to the daily emotional and physical wellbeing of women with breast cancer. Contrary to the tenets of the stress buffering model, these data suggest that the buffering effect of spousal support is attenuated when breast cancer related emotional and physical concerns reach high levels.

Passive avoidance learning among females as a function of Cloninger's temperament typology

Abstract Responsiveness to punishment cues has been historically associated with the socialization process, whereby individuals who are relatively unresponsive to the effects of punishment have been viewed as especially vulnerable to the development of antisocial behavior patterns. To date, much of the research on responsiveness to punishment has been conducted on male inmates or males identified as disinhibited. Almost no comparable research has been performed on females. The purpose of this study was to examine in a non-pathological female sample the extent to which constructs associated with Cloningers temperament typology predict passive avoidance errors (PAEs; or failures to inhibit previously punished responses) and omission errors (OEs; or failures to respond to stimuli associated with reward) produced during an interactive computer task. Hierarchical regression analyses indicated no main or interactive effects in the prediction of OEs. However, in the prediction of PAEs, the interaction of novelty seeking (NS) and harm avoidance (HA) was significant, whereby the combination of high NS and low HA was most strongly associated with PAE frequency. Subsequent analyses indicated that response speed in combination with reflection following punishment mediated the relationship between temperament dimensions and passive avoidance learning.

Men’s Psychological Functioning in the Context of Women’s Breast Cancer

Previous research indicates that men are affected when their female partners have breast cancer. However, little is known about what predicts mens psychological well-being in this context. The current investigation involved couples in which the woman had early stage breast cancer and explored the degree to which mens positive and negative well-being was related to womens well-being, womens physical symptoms, relationship functioning, and relationship duration. The findings indicate that all of these factors play a role and interact in predicting mens well-being. In particular, when women have a high level of physical symptoms, the typical associations between mens well-being with womens well-being and relationship adjustment no longer persist. Implications for working with couples addressing health problems are provided.

Partners empowered: a couple-based intervention for newly diagnosed cancer.

Cancer disrupts the lives of both patient and partner; often the patient and partner’s level of distress are similar [1]. Although grappling with strong emotional reactions, couples with cancer face treatment side effects, changes in family roles, and communication challenges. Although spousal support can positively impact patients’ adjustment [2], partners are challenged to provide support at a time when their resources may substantially exhausted [3]. Previous research has shown positive effects for couplebased interventions for cancer [4,5]; however, interventions that have specifically targeted enhancing the couple’s relationship have primarily been conducted with breast and prostate cancer populations and have been site and stage specific, thus limiting the impact of couple-based interventions. The current study examined the feasibility of a cognitive behavioral therapy communication-based couple framework developed for men and women with any diagnosis and stage of cancer. To our knowledge, marital satisfaction has not been examined as a moderator of couple-based interventions despite research findings that marital distress is associated with slowed recovery trajectories and poor outcomes [6]. We hypothesized that at posttest, patients and partners would report higher relationship satisfaction and that patients would report higher quality of life (QoF), and these effects would be moderated by relationship satisfaction. We hypothesized that distressed couples would benefit more from the intervention as they are in greater need of assistance.

Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial

Background Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. Methods Pilot randomised clinical trial with 3-month follow-up conducted at two academic medical centres. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomised after discharge home to 1 of 3 month-long interventions: a self-directed mobile app-based mindfulness programme; a therapist-led telephone-based mindfulness programme; or a web-based critical illness education programme. Results Among 80 patients allocated to mobile mindfulness (n=31), telephone mindfulness (n=31) or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomisation 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 (SD 3.8)) and usability (mean Systems Usability Score 89.1 (SD 11.5)). For secondary outcomes, mean values (and 95% CIs) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (−4.8 (−6.6, −2.9)), telephone (−3.9 (−5.6, −2.2)), education (−3.0 (−5.3, 0.8)); the Generalized Anxiety Disorder scale (mobile −2.1 (−3.7, −0.5), telephone −1.6 (−3.0, −0.1), education −0.6 (−2.5, 1.3)); the Post-Traumatic Stress Scale (mobile −2.6 (−6.3, 1.2), telephone −2.2 (−5.6, 1.2), education −3.5 (−8.0, 1.0)); and the Patient Health Questionnaire physical symptom scale (mobile −5.3 (−7.0, −3.7), telephone −3.7 (−5.2, 2.2), education −4.8 (−6.8, 2.7)). Conclusions Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led programme. A larger trial is warranted to formally test the efficacy of this approach. Trial registration number Results, NCT02701361.