Facing Spousal Cancer During Child-Rearing Years: Do Social Support and Hardiness Moderate the Impact of Psychological Distress on Quality of Life?

BACKGROUND: Partners of cancer patients report psychological distress and reduced quality of life. However, partners' mental health status and quality of life during child-rearing years and the influence of social support and hardiness on their well-being have not yet been studied. OBJECTIVE: The aim of this study was to describe psychological distress, quality of life, social support, and hardiness of the partners facing spousal cancer during child-rearing years and investigate whether social support or hardiness moderated the relationship between psychological distress and quality of life. METHODS: Cross-sectional data were collected in Norway from December 2013 to July 2015 as part of the Cancer-PEPSONE study. RESULTS: Five questionnaires were administered to 14 females and 21 males (n = 35). Participants reported more psychological distress and lower quality-of-life scores than other healthy Norwegian populations. Psychological distress seemed to be associated with their not being in control of their futures. Received social support moderated the effect of psychological distress on quality of life. CONCLUSIONS: Facing spousal cancer during child-rearing years seemed to have a substantial impact on partners' mental health and an adverse impact on their quality of life. Accordingly, these partners' self-care abilities may be reduced. Received social support may reduce the multiple burdens and consequently allow for enhancement of self-care. IMPLICATIONS FOR PRACTICE: Interventions should aim to improve the social support provided to child-rearing partners, which may improve their quality of life. Providing adequate information about their partner's cancer illness and treatment may enhance their feelings of control, which may be beneficial for their mental health status.

Hardiness, avoidance coping, and alcohol consumption in war veterans: A moderated-mediation study.

Military personnel often engage in excessive alcohol use after returning from deployments. Thus far, research has paid scant attention to personality factors that may increase or diminish the risk for increased alcohol consumption in this population. The present study explores how psychological hardiness, avoidance coping, and stress exposure may interact to influence alcohol consumption patterns in soldiers following deployment. U.S. Army National Guard soldiers (N = 357) were surveyed shortly after returning from combat operations in Afghanistan. Conditional process analysis was used to test for mediation and moderation effects. Mediation effects were further tested in a replication sample of Norwegian Army soldiers (N = 230) deployed to Kosovo. Findings show that hardiness is a significant (negative) predictor of increased alcohol use and that this relation is mediated by avoidance coping. Further, this effect was moderated by combat stress exposure in the U.S. sample, such that the mediation is stronger for those with greater exposure (moderated-mediation). Avoidance coping also mediated the effects of hardiness on alcohol consumption in the Norwegian sample. These findings suggest that avoidance coping and hardiness may be fruitful areas for interventions aimed at reducing risky drinking in high-stress groups like the military.

The combined influence of hardiness and cohesion on mental health in a military peacekeeping mission: A prospective study.

A large number of studies have shown that hardiness and cohesion are associated with mental health in a military context. However, most of them are presented without controlling for baseline mental health symptoms, which is their most significant source of error. The present study investigates the combined effect of hardiness and cohesion in a prospective design, controlling for baseline levels of symptoms among Norwegian personnel serving in a peacekeeping operation in Kosovo. Multivariate regression analyses were performed in which self-reported mental health complaints were regressed on our explanatory variables. Our findings suggest that both cohesion and hardiness contributed to increased stress resiliency, as measured by a lower level of reported mental health complaints. Our baseline measure of mental health accounted for a larger proportion of the variance than our other predictors. A significant interaction between cohesion and hardiness suggested a combined effect, over and above the individual contributions of the predictors. For individuals who scored high on hardiness, cohesion levels did not influence levels of mental health complaints. Individuals who scored low on hardiness, on the other hand, reported lower levels of mental health complaints when cohesion levels were high.

Reduced heart rate variability in chronic alcohol abuse: relationship with negative mood, chronic thought suppression, and compulsive drinking.

BACKGROUND: Previous research suggests that heart rate variability (HRV) may be an important factor in various maladaptive psychological conditions. METHODS: This study was conducted to investigate vagal tone assessed as tonic vagally mediated heart rate variability in alcoholic (n = 49) and control subjects (n = 45). RESULTS: Alcoholic subjects had faster heart rate and lower preimaginary exposure levels of HRV compared with the control group. An increase in HRV was observed in the alcoholic group when subjects were exposed to an imaginary alcohol script. Tonic HRV was found to be related inversely to negative mood and chronic thought suppression and positively to positive mood. Furthermore, the compulsive subscale of the Obsessive Compulsive Drinking Scale (OCDS) was inversely related to HRV during the imaginary alcohol exposure. CONCLUSIONS: It is concluded that the findings are in agreement with the neurovisceral integration model of affective regulation, which claims that dysfunctional psychologic states are rooted in an impaired inhibitory mechanism that is associated with low HRV.

Craving for alcohol and pre-attentive processing of alcohol stimuli.

The present study was designed to test the hypothesis of unconscious attending to alcohol-related information in alcoholics experiencing a high level of craving for alcohol. Subjects included a group of alcoholics (n=34) divided by a median split on a craving measure into two groups labeled as 'high craving' (n=18) and 'low craving' (n=16) alcoholics, and a non-alcoholic control group (n=39). The cardiovascular reactions of these groups were compared after their exposure to masked and unmasked alcohol and control stimuli. As expected the 'high craving' alcoholics showed an immediate heart rate deceleration after exposure to masked and non-consciously accessible alcohol pictures. The 'high craving' alcoholics reported a small but significant increase in difficulty resisting a drink after exposure to masked alcohol pictures. When the alcohol pictures were presented unmasked a significant increase was found in both high and low craving alcoholics on consciously expressed urges, fidgeting and reduced coping with temptation to drink. The 'high craving' alcoholics had lower tonic heart rate variability compared to the control group and the level of craving was positively associated with salivation during the exposure to all picture types. The findings generally support the psychobiological theory of craving, which suggests that the uncontrollability of the craving experience is rooted in unconscious processing of drug-related information.

Preattentive processing of alcohol stimuli.

An experiment was conducted to test the automatic analysis of briefly presented alcohol stimuli in alcohol-dependent individuals. Alcoholics and controls were exposed to four different conditions: two brief (30 ms) and two long (130 ms) exposure conditions, each containing alcoholic and non-alcoholic pictures. Heart rate (HR) interbeat intervals were recorded and phasic cardiac responses assessed. Alcoholics had a stronger initial HR deceleration after exposure to masked alcohol slides compared with masked control slides, indicating a preattentive analysis of alcohol stimuli. This initial HR deceleration in the masked condition suggests an automatic attentional focusing to degraded alcohol cues. No such attentional effect was found when the pictures were presented unmasked and were clearly perceived. The implication of these results for the understanding of relapse in addictive behavior is discussed.

Attentional and physiological characteristics of patients with dental anxiety.

Twenty patients with dental anxiety were investigated while seated in a dental chair in a dental clinic. Heart rate (HR), heart rate variability (HRV), and skin conductance level (SCL) were recorded while the patients were exposed to scenes of dental treatment as well as a Stroop attentional task. Results showed an attentional bias with longer manual reaction times (RT's) to the incongruent compared to the congruent color words as well as the threat compared to the neutral words. Longer RT's to the incongruent and the threat words were found in the low HRV patients compared to the high HRV patients. Furthermore, all patients showed an increase in HR during exposure and the Stroop task compared to baseline. The HRV showed a decrease during the exposure and the Stroop task compared to baseline. HR and HRV did not differ between exposure and the Stroop task. Moreover, HR and HRV did not return to baseline levels during the recovery period. The SCL showed an increase from baseline to exposure, from exposure to the Stroop task and a decrease in the recovery phase. Results showed the importance of vagal cardiac control in attentional, emotional, and physiological processes in patients suffering from dental fear.