The relationship of perfectionism with psychological symptoms in cancer patients and the contributing role of hyperarousability and coping.

OBJECTIVE: Significant levels of anxiety, depression and insomnia symptoms are found in cancer patients. Perfectionism, arousability and coping have been associated with these psychological symptoms in the general population but their role among cancer patients remains to be assessed. This study examined the longitudinal relationships between perfectionism and psychological symptoms (anxiety, depression, insomnia), and the intermediate role of the arousability trait and coping strategies. DESIGN: Participants (N = 853) completed the Multidimensional Perfectionism Scale, the Coping with Health Injuries and Problems questionnaire and the Arousal Predisposition Scale at the perioperative period (T1), and the Hospital Anxiety and Depression Scale and the Insomnia Severity Index two months later (T2). RESULTS: Higher levels of perfectionism (T1) were correlated with greater symptoms of anxiety, depression and insomnia (T2). Moderated mediation models indicated that arousability contributed to the association of perfectionism with all symptoms, with stronger associations found in men than in women. Coping was a significant pathway between perfectionism and anxiety, with associations of a comparable magnitude across sexes. CONCLUSION: If these results are replicated by future longitudinal studies, they would suggest that perfectionist cancer patients are at a higher risk of experiencing psychological symptoms, partly through their hyperarousability and the coping strategies they use.

Filicidal women: jail or psychiatric ward?

OBJECTIVE: This study aims to examine the legal procedure that women who are charged with killing their children experience and to compare the variables that discriminate between those found guilty and those who received a medical disposition. METHOD: The sample comprises 32 adult women who killed their biological children in the province of Quebec over an 11-year period (1981 to 1991). RESULTS: Of the sample, 18 women were found guilty, and 14 received a medical disposition. Of those who were the object of a penal disposition, most received a sentence that exceeded 2 years. Women who were sentenced to prison had a lower socioeconomic status and, compared with those who received a medical disposition, were more likely to have had a criminal and substance abuse history. Further, this latter subgroup of women were more likely to have a psychiatric history, to suffer from psychotic symptoms, and to become oriented to the mental health system immediately after their offense. CONCLUSIONS: These comparative results suggest that women's profiles differ according to some descriptive variables. From a clinical point of view, however, these results do not suggest that a different approach with respect to treatment of filicidal women or prevention of filicide would be more appropriate.