Distress, coping, and social support among rural women recently diagnosed with primary breast cancer.

This study examined distress, coping, and group support among a sample of rural women who had been recently diagnosed with breast cancer. We recruited 100 women who had been diagnosed with primary breast cancer at one of two time points in their medical treatment: either within a window up to 3 months after their diagnosis of breast cancer, or within 6 months after completing medical treatment for breast cancer. Their mean age was 58.6 years (SD = 11.6), and 90% were of white/European American ethnicity. Women completed a battery of demographic and psychosocial measures prior to being randomized into a psychoeducational intervention study, and then again 3 months later at a follow-up assessment. The focus of this article is on the women's self-reported psychosocial status at baseline. Many of the women experienced considerable traumatic stress regarding their breast cancer. However, this distress was not reflected in a standard measure of mood disturbance that is frequently used in intervention research (the Profile of Mood States). The average woman considered her diagnosis of breast cancer to be among the four most stressful life events that she had ever experienced. Also, women on average reported a high level of helplessness/hopelessness in coping with their cancer. On average, women felt that they "often" (but not "very often") received instrumental assistance, emotional support, and informational support. Women varied considerably in which kind of social group provided them with the most support, with as many reporting that they found the greatest support in spiritual/church groups or within their family units as with breast or general cancer groups. These results suggest that among these rural women with breast cancer, distress with the diagnosis of breast cancer must be carefully assessed, as women who are highly distressed about their breast cancer may not report general mood disturbance. Furthermore, the kinds of groups that rural women with breast cancer experience as most supportive need to be identified so that psychosocial interventions can be matched to breast cancer patients' individual needs.

Post-event review in older and younger adults: improving memory accessibility of complex everyday events.

Recalling an event at 1 time often increases the likelihood that it will be remembered at a still later time. The authors examined the degree to which older and younger adults' memory for everyday events that they watched on a videotape was improved by later seeing photographs or reading brief verbal descriptions of those events. Both older and younger adults recalled more events, in greater detail, with than without review. Verbal descriptions enhanced later recall to the same degree as reviewing photographs. Younger adults generally gained more from review than older adults on measures of the absolute number of details recalled and when facilitation was assessed relative to a no-review control condition, but not when memory for reviewed events was expressed as a proportion of each individual's total recall. Post-event review has clear potential practical benefits for improving memory of older adults.

Social support, life stress, pain and emotional adjustment to advanced breast cancer.

The purpose of this study was to examine relationships between emotional adjustment to advanced breast cancer, pain, social support, and life stress. The cross-sectional sample was compromised of 102 women with metastatic and/or recurrent breast cancer who were recruited into a randomized psychosocial intervention study. All women completed baseline questionnaires assessing demographic and medical variables, social support, life stress, pain, and mood disturbance. Three types of social support were assessed: (1) number of persons in support system; (2) positive support; and (3) aversive support. On the Profile of Mood States (POMS) total score, we found significant interactions between life stress and social support; having more people in the patient's support system was associated with less mood disturbance, but only among patients who had undergone greater life stress. Also, aversive social contact was significantly related to total mood disturbance (POMS), and having more aversive social contact was particularly associated with total mood disturbance (POMS) among patients who had undergone greater life stress. Pain intensity was associated with greater total life stress, and was not significantly related to social support. These results are consistent with the 'buffering hypothesis' that social support may shield women with metastatic breast cancer from the effects of previous life stress on their emotional adjustment; however, aversive support may be an additional source of life stress associated with emotional distress. Also, pain is greater among women with greater life stress, regardless of social support.

Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study.

The authors investigated the emergence of gender differences in clinical depression and the overall development of depression from preadolescence to young adulthood among members of a complete birth cohort using a prospective longitudinal approach with structured diagnostic interviews administered 5 times over the course of 10 years. Small gender differences in depression (females greater than males) first began to emerge between the ages of 13 and 15. However, the greatest increase in this gender difference occurred between ages 15 and 18. Depression rates and accompanying gender differences for a university student subsample were no different than for a nonuniversity subsample. There was no gender difference for depression recurrence or for depression symptom severity. The peak increase in both overall rates of depression and new cases of depression occurred between the ages of 15 and 18. Results suggest that middle-to-late adolescence (ages 15-18) may be a critical time for studying vulnerability to depression because of the higher depression rates and the greater risk for depression onset and dramatic increase in gender differences in depression during this period.

Effectiveness of a training program for enhancing therapists' understanding of the supportive-expressive treatment model for breast cancer groups.

This study evaluated a training program for leaders of supportive-expressive psychotherapy groups for breast cancer patients. Twenty-four mental health/medical cancer care professionals completed two training phases and were tested for their understanding of the treatment model. Participants' understanding was enhanced as a result of the training program. This study demonstrates that a brief training program can improve therapists' understanding of the treatment model and demonstrates an effective method of evaluation. Future research should examine how performance on these tests generalizes to performance when leading a supportive-expressive group.

False recollection induced by photographs: a comparison of older and younger adults.

Looking at photographs constitutes an important everyday memory activity for older adults. The authors found that reviewing photographs of events seen earlier in a videotape increases the likelihood that both older and younger adults remember specific details from the reviewed event (W. Koutstaal, D. L. Schacter, M. K. Johnson, K. E. Angell, & M. S. Gross, 1977). In the present study, the authors report 2 experiments demonstrating that photo review can also produce false recollection in elderly adults: After reviewing photos of events that had not been shown earlier in a videotape, older but not younger adults were later more likely to "remember" that those events had been shown in the videotape. False recollection induced by photo review appears to reflect an age-related deficit in source-monitoring abilities.

Coping styles associated with psychological adjustment to advanced breast cancer.

The aim of this study was to determine whether psychological adjustment to advanced breast cancer was positively associated with expressing emotion and adopting a fighting spirit and negatively associated with denial and fatalism. Total mood disturbance on the Profile of Mood States was used as the measure of psychological adjustment. The Courtauld Emotional Control Scale measured emotional expression, and the Mental Adjustment to Cancer measured fighting spirit, denial, and fatalism. The sample included 101 women with a diagnosis of metastatic or recurrent breast cancer. Fighting spirit and emotional expressiveness were found to be associated with better adjustment. No association was found between mood disturbance and denial or fatalism. Because this was a cross-sectional study, no conclusions regarding a causal relationship between adjustment and emotional expressiveness or adjustment and fighting spirit were possible.

Ibuprofen compared with ibuprofen plus caffeine after third molar surgery.

OBJECTIVES: To compare the relative merits of single doses of ibuprofen and ibuprofen plus caffeine in the treatment of pain after third molar removal. DESIGN: Randomised, double-blind, placebo-controlled, single-dose parallel-group comparison of placebo, ibuprofen 200 and 400 mg with ibuprofen 200 mg plus 50, 100 or 200 mg of caffeine. SUBJECTS: 161 patients undergoing lower third molar removal. RESULTS: All active treatments produced significant analgesia and mood elevation compared with placebo. There was no significant difference in the effects of 200 and 400 mg of ibuprofen. Adding caffeine to 200 mg ibuprofen produced significantly more analgesic effect at 45 and 60 min than ibuprofen 200 mg alone. Ten patients reported 11 adverse effects, none in the highest caffeine dose group. CONCLUSIONS: Caffeine increased the analgesic effect of ibuprofen 200 mg, through an earlier onset of analgesic effect. This was achieved in this single dose context without problematic adverse effects.

Cognition and life stress in depression: cognitive factors and the definition, rating, and generation of negative life events.

The relationship between cognitive factors and different conceptualizations and measures of life stress poses important questions for contemporary theories of depression. We examined whether cognitive factors (dysfunctional attitudes and attributional style) are related to the definition, rating, and generation of negative life events. Life events were assessed with both subjective self-report and more objective interview-based methods in endogenously depressed outpatients. The results partially support the hypothesis that cognitive factors are related to definition and severity ratings of self-report measures of particular types of life events. These relationships held primarily for achievement, as compared with interpersonal, events. The results also support the hypothesis that elevated scores on measures of cognition are associated with the number of objectively defined events occurring prior to the onset of depression, suggesting that some patients may generate the life events that in turn may initiate a depressive episode.

Effects of trimethyltin on repeated acquisition (learning) in the radial-arm maze.

Trimethyltin (TMT) was used as a positive control neurotoxicant to evaluate a repeated acquisition procedure for the 8-arm radial maze. Ten male Long-Evans rats were trained to collect a single food pellet at the end of each baited arm on each trial of a daily 12-trial test session. Four of the eight arms were baited on all trials of a given session. The set of four baited arms was changed each day: thus the rats were required to learn a new set of baited arms in each session. In trained rats, error frequencies (entries into unbaited arms) declined from about 4 on Trial 1 to less than 1 on Trials 4-12 in each session: this within-session error reduction thus defined an acquisition baseline which was evaluated for its sensitivity to TMT. Learning was impaired after 7 mg/kg (iv) TMT, as shown by a slower decline in within-session error frequencies in all treated rats. Errors and response times were elevated for 5 weeks after TMT but returned to control levels thereafter. Histological examination of hippocampi showed damage in all treated rats 18 weeks after treatment; however, no significant relationship between degree of damage and behavioral effect was observed. Analysis of errors showed that TMT more strongly impaired the rats' ability to avoid arms in the current unbaited set than those baited arms already entered on a given trial (i.e., working memory). These dissociations between behavior and hippocampal morphology in terms of time course, magnitude of effect across animals, and error type suggest that performance of this task does not depend upon hippocampal integrity, as do other tasks involving spatial working memory. Recovery of function in this kind of task may shed light on processes of neural plasticity after exposure to neurotoxic compounds.