Web-Based Alcohol Intervention in First-Year College Students: Efficacy of Full-Program Administration Prior to Second Semester.

BACKGROUND: Commercially available, web-based interventions for the prevention of alcohol use are being adopted for universal use with first-year college students, yet few have received empirical evaluation. OBJECTIVES: This randomized controlled trial investigated the effectiveness of a novel, commercially available, personalized web-based alcohol intervention, Alcohol-Wise (version 4.0, 3rd Millennium Classrooms), on multiple measures of alcohol consumption, alcohol consequences, alcohol expectancies, academic achievement, and adaptation to college in first-year students. METHOD: Participants received Alcohol-Wise either prior to first semester or were waitlisted and received the intervention second semester. As longitudinal effectiveness was of interest, follow-up surveys were conducted 10 weeks (n = 76) and 24 weeks (n = 64) following the web-based alcohol intervention. RESULTS: Completion of Alcohol-Wise had effects on academic achievement. Specifically, at the 24 week follow-up, academic achievement was higher in participants who received the intervention first semester of their freshman year as compared to the waitlist control. The incremental rise in heavy episodic drinking during the first semester of college was also reduced in waitlisted participants by Alcohol-Wise administration prior to second semester. Conclusion/Importance: Implications for the timing of web-based alcohol interventions to include administration prior to both first and second semesters of the freshman year are discussed.

Protective buffering and psychological distress among couples coping with breast cancer: The moderating role of relationship satisfaction.

This study examined whether the association between protective buffering and psychological distress was moderated by relationship satisfaction. Protective buffering is defined as hiding worries, denying concerns, and yielding to one's partner in an effort to avoid disagreement and reduce one's partner's upset and burden. Two hundred thirty-five women diagnosed with early stage breast cancer and their partners completed measures of protective buffering, psychological distress, and relationship satisfaction at 3 time points over an 18-month period after cancer diagnosis. The authors hypothesized that protective buffering would result in more distress among patients and partners reporting higher relationship satisfaction than among patients and partners reporting lower levels of relationship satisfaction. Patients' protective buffering predicted more distress among patients rating their relationships as more satisfactory, whereas the patients' buffering did not predict distress among patients rating their relationships as less satisfactory. Partner relationship satisfaction also moderated the association between patients' buffering and partners' distress. These findings elucidate conditions under which protective buffering may have detrimental effects.

Prevalence and predictors of psychological distress among women with ovarian cancer.

PURPOSE: To identify the prevalence of psychological distress among women with ovarian cancer and to examine the association between these symptoms of distress and demographic and medical variables. PATIENTS AND METHODS: Participants were 143 women with ovarian cancer. Forty-eight percent of participants had been diagnosed with advanced-stage disease (stage III or IV) and most (80%) were currently receiving treatment. Psychological distress was assessed with the following measures: the Beck Depression Inventory, the Mental Health Inventory, the Impact of Events Scale, and a questionnaire regarding mental health service use. RESULTS: Approximately one fifth of women reported moderate to severe levels of distress, and more than half reported high stress responses to their cancer and its treatment. Most participants (60%) were not using any mental health services or psychotropic medications. There was also evidence to suggest that younger patients, patients with more advanced or recurrent disease, and patients who had more recently been diagnosed with ovarian cancer experienced greater psychological distress. CONCLUSION: These findings indicate that psychological distress and high stress responses to cancer are prevalent among women with ovarian cancer, suggesting they should be carefully evaluated to determine whether treatment for these symptoms is warranted.

Ovarian cancer patients' psychological distress: the role of physical impairment, perceived unsupportive family and friend behaviors, perceived control, and self-esteem.

Although research has indicated that illness-related and interpersonal stress are associated with greater psychological distress among cancer patients, little empirical attention has been given to mechanisms that account for these relationships. In the present study, 2 mechanisms for the association between illness-related stress (physical impairment) and interpersonal stress (family and friend unsupportive responses) and psychological distress of 143 ovarian cancer patients were examined cross-sectionally. Separate structural equation models tested whether physical impairment impacted patients' distress via decrements in perceived control over their illness and whether unsupportive behaviors impacted patients' distress via decrements in patients' self-esteem. Results supported the proposed models and suggest that perceived control and self-esteem are 2 mechanisms for explaining how illness-related and interpersonal stress may be associated with psychological distress among women with ovarian cancer.

Change in the centrality of women's multiple roles: effects of role stress and rewards.

OBJECTIVES: To examine (a) change versus stability over one year in four social roles occupied by 182 midlife women (parent care provider, mother, wife and employee), (b) increases in role stress and increases in role rewards as predictors of change in centrality, and (c) whether increases in stress or increases in rewards were stronger predictors when the 2 were considered simultaneously. METHOD: Interviews were conducted at 2 time points approximately 1 year apart. Participants were asked to rate the personal importance of each role on a scale of 1 to 10. Stress and rewards in each role were also assessed. RESULTS: Analyses revealed considerable change in role centrality, especially in the parent-care and employee roles. Increases in wife and employee stress were associated with decreases in the centrality of these roles, whereas increases in rewards in each of the four roles were related to increases in the centrality of the respective roles. When considered simultaneously, role rewards were stronger predictors of change in centrality than role stress. DISCUSSION: These findings suggest that the centrality of a social role can change over time in response to stressful and rewarding role experiences.

The impact of email recruitment on our understanding of college smoking.

Email recruitment is growing in popularity; however, this convenience sampling method may yield very different results from prior convenience sampling methods. Participants in the current study were 825 undergraduate students, 446 recruited through a campus wide email and 379 recruited through Introductory Psychology courses, who completed an on-line survey on smoking and health. Outcomes varied significantly by group. Introductory Psychology students reported higher smoker self-concept, more pros of smoking, and were more likely to view smoking as a method of negative affect reduction. The current study suggests that recruitment method can bias our understanding of smoking behaviors among college students.

Cancer-specific self-efficacy and psychosocial and functional adaptation to early stage breast cancer.

BACKGROUND: Although self-efficacy is considered a key psychological resource in adapting to chronic physical illness, this construct has received less attention among individuals coping with cancer. PURPOSE: To examine changes in cancer self-efficacy over time among women with early stage breast cancer and associations between task-specific domains of self-efficacy and specific psychological, relationship, and functional outcomes. METHODS: Ninety-five women diagnosed with early stage breast cancer completed surveys postsurgery and 1 year later. RESULTS: Cancer-related self-efficacy was relatively stable over 1 year, with only 2 domains of efficacy-(a) Activity Management and (b) Self-Satisfaction-evidencing significant increases over the 1-year time period. Cross-sectional findings were relatively consistent with predictions and suggested that specific domains of self-efficacy were more strongly related to relevant domains of adaptation. Longitudinal findings were not as consistent with the domain-specificity hypothesis but did suggest several predictive associations between self-efficacy and outcomes. Personal Management self-efficacy was associated with higher relationship satisfaction, higher Communication Self-Efficacy was associated with less functional impairment, and higher Affective Management self-efficacy was associated with higher self-esteem 1 year later. CONCLUSIONS: Specific domains of cancer-related self-efficacy are most closely related to relevant areas of adaptation when considered cross-sectionally, but further study is needed to clarify the nature of these relationships over time.

Cancer-related relationship communication in couples coping with early stage breast cancer.

This longitudinal study examined the association between three types of communication strategies couples may use to handle stressors they experience during and after breast cancer treatment and psychological distress and relationship satisfaction of women with early stage breast cancer and their partners. Mutual constructive communication, mutual avoidance, and demand-withdraw communication strategies as well as psychological distress and marital satisfaction were rated by 147 patients and 127 partners during cancer treatment and 9 months later. Mutual constructive communication was associated with less distress and more relationship satisfaction for both patient and partner. Demand-withdraw communication was associated with higher distress and lower relationship satisfaction for both patient and partner. Mutual avoidance was associated with more distress for patient and partner but was not associated with relationship satisfaction. The negative association between mutual constructive communication and patient distress was stronger for patients with more physical impairment. Patients' perceptions of mutual constructive communication and mutual avoidance were associated with partners' distress, and patients' perceptions of mutual constructive and demand/withdraw communication were associated with partners' marital satisfaction. Clinical implications for couple-focused communication skills training for cancer patients and their partners are discussed.