Increased tobacco and alcohol use among women with joint hypermobility: a way to cope with anxiety?

Joint hypermobility (JH) is a common trait of heritable disorders of the connective tissue which has been identified as a risk factor for anxiety states. Anxiety and other negative emotions lead some people to use tobacco and alcohol as a coping strategy. The purpose of this study was to examine JH in relation to the consumption of these psychoactive substances and the associated anxiety and coping strategies. A cross-sectional sample of 305 female college students completed self-administered questionnaires on JH, tobacco and alcohol use, state and trait anxiety, and coping strategies. The prevalence of JH in the final sample (N = 301) was 51.8 %. The percentage of smokers, smokers using tobacco to calm anxiety, at-risk drinkers, tobacco and alcohol users, and the number of standard drinks consumed per week were significantly higher among females with JH than among those without it. The percentage of participants with severe state anxiety was significantly higher in the JH group, as were the emotion-focused coping score. The results of the logistic regression analysis showed that the odds of being assessed with JH were greater in those who consume tobacco and alcohol. This study provides evidence that women with JH report higher levels of state anxiety than non-JH women and use emotion-focused coping (i.e., efforts to regulate affect) more than any other coping strategies to deal with stress. These factors may help explain the increase in tobacco and alcohol use observed in this population.

Psychological effect of exercise in women with breast cancer receiving adjuvant therapy: what is the optimal dose needed?

BACKGROUND: Several meta-analyses have examined the role of exercise interventions in improving psychological outcomes in cancer survivors but most did not focus on adjuvant therapy period and did not investigate the optimal dose of exercise needed. The present meta-analysis examines the impact of exercise interventions delivered at this particular period on fatigue, anxiety, depression, and quality of life (QoL) as well as dose-response relationships between volume of prescribed exercise and these psychological outcomes. MATERIALS AND METHODS: Randomized, controlled trials that proposed an exercise intervention to patients with breast cancer undergoing chemotherapy and/or radiotherapy were systematically identified and coded. Psychological outcomes effect sizes were calculated and analyzed for trends using linear and quadratic regressions. RESULTS: Pooled effects of the 17 included studies revealed improvement for all outcomes, significant for fatigue, depression, and QoL with pooled estimates ranging from 0.2 to 0.5 favoring intervention. Significant inverse associations of the volume of prescribed exercise with fatigue and QoL were observed. CONCLUSIONS: Exercise intervention improved fatigue, depression, and QoL in patients with breast cancer receiving adjuvant therapy. Prescription of relatively low doses of exercise (<12 MET h/week) consisting in ∼90-120 min of weekly moderate physical exercise seems more efficacious in improving fatigue and QoL than higher doses.

Dimensions of cancer locus of control scale as predictors of psychological adjustment and survival in breast cancer patients.

The Cancer Locus of Control Scale, to investigate specific beliefs of control in cancer patients, was validated previously with an English-speaking population. This study tested the construct and concurrent validity of a 17-item French version of the scale and explored its relations with psychological adjustment and with adaptation assessed two years later. In a sample of 157 women diagnosed with a first breast cancer, the French version was administered along with the Body Image Questionnaire, the State-Trait Anxiety Inventory, the Perceived Stress Scale, the Social Support Questionnaire, and the Ways of Coping Checklist. A factor analysis performed on scores identified the three original factors: internal causal attribution, control over the course of the illness, and religious control. Internal causal attribution was associated with high scores for state and trait anxiety, negative body image, emotion-focused coping, and problem-focused coping. Control over the course of the cancer was positively associated with scores on both problem- and emotion-focused coping. Religious control was negatively associated with perceived stress. Emotional adjustment and quality of life were assessed in 59 of the 157 breast cancer patients two years after diagnosis and original testing. Hierarchical regression analyses indicated that internal causal attribution significantly predicted 38.1% of the variance in rated state anxiety. None of the dimensions of the Cancer Locus of Control Scale predicted the duration of survival measured two years later in 75 of the 157 patients.

Haematological cancer and quality of life: a systematic literature review.

The aim of this study is to examine the impact of haematological cancers on quality of life (QoL). A review of the international literature was conducted from the databases 'PsycInfo' and 'Medline' using the keywords: 'haematological cancer', 'quality of life', 'physical', 'psychological', 'social', 'vocational', 'professional', 'economic', 'cognitive', and 'sexual'. Twenty-one reliable studies were analysed. Among these studies, 12 showed that haematological cancer altered overall QoL, 8 papers found a deterioration of physical dimension, 8 papers reported on functional and role dimensions, 11 papers reported on the psychological component and 9 on the social component. Moreover, one study and two manuscripts, respectively, reported deteriorated sexual and cognitive dimensions. Our review demonstrates that the different dimensions of QoL are deteriorated by haematological malignancies and, probably, by the side effects of treatment.

[Coping strategies utilized by asthma patients]. / Stratégies d'ajustement habituelles mises en place par des patients asthmatiques.

In the Lazarus' transactional model of stress, each individual when facing a stressful situation, set up specific adjustement strategies called coping, including a meaningful pattern of cognitive, behavioral, emotional and somatic responses. Coping strategies used by asthmatic patient are relatively unknown. The objective of this study was to assess the usual coping strategies. We administered the WCC (a shortened version of Lazarus and Folkman's questionnaire) to 116 asthmatic patients and 880 healthy adults French subjects (males and females). A principal component analysis, followed by varimax rotations yielded three factors accounting for about 68.2% of the total variance. They were interpreted as Problem-focused, Emotion-focused and Social-support seeking types of coping. These two first dimensions of coping were closed to those generally described in the literature. Asthmatic patients used more emotion-focused strategy than the control group. These results and their theoretical and practical implications are discussed.

[The patient's representation of asthma. Preliminary results of a survey]. / Représentation de l'asthme par le patient. Résultats préliminaires d'une étude sémiométrique.

There is often a discrepancy between doctors' and patients' points of view on asthma. However, few studies have been devoted to the patients' representation of asthma. In this study 27 subjects, with moderate asthma, had to choose from a list of 35 groups of words and expressions, those which look to them to best evoke asthma. The results of this descriptive study show that "allergy" is the most frequently chosen term associated by patients with "suffocate", "attack", "heredity", and "psychic". Asthmatic patients minimise disease severity and refuse to be categorised as ill; they reject terms stigmatising asthmatic subject and the dangerousness of their disease. However, they recognise that asthma has psychological repercussions and prefer self-care. They consider drugs as dangerous and are afraid of their addiction and toxicity. These results have implications on information and education of asthmatic patients. To identify, for each patient, what is his/her representation of his/her disease would be very useful to provide patients with an adapted and personalized help for the management of his/her disease.