A Validation Study of the Mini-IPIP Five-Factor Personality Scale in Adults With Cancer.

The Mini International Personality Item Pool (Mini-IPIP) is a brief measure of the Five-Factor Model of personality with documented validity in healthy samples of adults and could be useful for assessing personality in patient populations such as individuals with cancer. The purpose of this study was to examine the psychometric properties of the Mini-IPIP in 2 samples of adults with cancer. A sample of 369 (Sample 1) and a sample of 459 (Sample 2) adults with cancer completed an online survey including the Mini-IPIP. To assess criterion validity, Sample 2 completed measures of emotional distress. Analyses included internal consistency (Samples 1 and 2), confirmatory factor analyses (CFAs; Samples 1 and 2), and correlations and a structural regression model to examine the associations between the 5 personality factors and emotional distress (Sample 2 only). Results showed that the Mini-IPIP demonstrated levels of internal consistency and CFA model fit that were similar to previous validation studies conducted in the general population. Consistent with prior research and theory, this study also found that personality factors measured by the Mini-IPIP were associated with measures of emotional distress in Sample 2. These findings suggest the potential utility of the Mini-IPIP in both research and clinical settings involving individuals with cancer.

Disparities in Social Health by Sexual Orientation and the Etiologic Role of Self-Reported Discrimination.

Some past work indicates that sexual minorities may experience impairments in social health, or the perceived and actual availability and quality of one's social relationships, relative to heterosexuals; however, research has been limited in many ways. Furthermore, it is important to investigate etiological factors that may be associated with these disparities, such as self-reported discrimination. The current work tested whether sexual minority adults in the United States reported less positive social health (i.e., loneliness, friendship strain, familial strain, and social capital) relative to heterosexuals and whether self-reported discrimination accounted for these disparities. Participants for the current study (N = 579) were recruited via Amazon's Mechanical Turk, including 365 self-identified heterosexuals (105 women) and 214 sexual minorities (103 women). Consistent with hypotheses, sexual minorities reported impaired social health relative to heterosexuals, with divergent patterns emerging by sexual orientation subgroup (which were generally consistent across sexes). Additionally, self-reported discrimination accounted for disparities across three of four indicators of social health. These findings suggest that sexual minorities may face obstacles related to prejudice and discrimination that impair the functioning of their relationships and overall social health. Moreover, because social health is closely related to psychological and physical health, remediating disparities in social relationships may be necessary to address other health disparities based upon sexual orientation. Expanding upon these results, implications for efforts to build resilience among sexual minorities are discussed.

Explaining Extremity in Evaluation of Group Members: Meta-Analytic Tests of Three Theories.

A meta-analysis that included more than 1,100 effect sizes tested the predictions of three theoretical perspectives that explain evaluative extremity in social judgment: complexity-extremity theory, subjective group dynamics model, and expectancy-violation theory. The work seeks to understand the ways in which group-based information interacts with person-based information to influence extremity in evaluations. Together, these three theories point to the valence of person-based information, group membership of the evaluated targets relative to the evaluator, status of the evaluators' ingroup, norm consistency of the person-based information, and incongruency of person-based information with stereotype-based expectations as moderators. Considerable support, but some limiting conditions, were found for each theoretical perspective. Implications of the results are discussed.

Minority stress and inflammatory mediators: covering moderates associations between perceived discrimination and salivary interleukin-6 in gay men.

Physical health disparities by sexual orientation are widespread yet under-investigated. Drawing upon theories of biological embedding of social adversity, we tested whether minority stress (in the form of perceived discrimination) is associated with salivary interleukin-6 (IL-6), an inflammatory mediator. Furthermore, we examined whether covering, a strategy involving downplaying a stigmatized social identity, modified this association. A community sample (N = 99) of gay men (n = 78) and lesbian women (n = 21) completed self-report measures of minority stress and identity management and provided saliva samples which were assayed for IL-6. Among gay men, results from generalized linear models supported a hypothesized interaction between perceived discrimination and covering, such that perceived discrimination was predictive of higher levels of IL-6 for those who engaged in less covering but not for those who engaged in more covering. This interaction was robust to a number of potential covariates (alcohol, medication, body mass index, race and age). Results for lesbian women suggested a different pattern: the only statistically significant association detected was between greater perceived discrimination and lower levels of IL-6. Findings from the current study point to an important role for inflammatory processes in understanding and remediating health disparities based upon sexual orientation that stem from exposure to prejudice and discrimination.

Perceived discrimination as a stressor for close relationships: identifying psychological and physiological pathways.

Approaching the inverse association between perceived discrimination and close relationship functioning from a stress and coping framework, we propose and test a novel model incorporating psychological (emotion dysregulation) and physiological (chronic inflammation) pathways. Analyses of data from a sample of African American participants (N = 592) enrolled in the Midlife in the United States (MIDUS) study revealed support for the proposed model. Specifically, results from structural equation modeling analyses showed that perceived discrimination was indirectly associated with increased emotion dysregulation (venting and denial) through stressor appraisals and directly associated with increased inflammation (interluekin-6, e-selectin and c-reactive protein). Furthermore, relationship strain with family, friends and spouses was associated with greater levels of emotion dysregulation and chronic inflammation. Overall, the proposed model fit the data well and provides support for new avenues of research on the social, psychological and physiological correlates of perceived discrimination and close relationship functioning. To conclude, evidence for the proposed biopsychosocial model is summarized and directions for future research on these topics are discussed.

Rural and urban breast cancer patients: health locus of control and psychological adjustment.

OBJECTIVE: This study examines the moderating influence of rural residence on the associations between health locus of control (HLC) beliefs and psychological well-being. METHOD: Two hundred and twenty-four breast cancer patients were surveyed. RESULTS: The results revealed that rurality interacted with HLC beliefs in predicting psychological adjustment. The pattern indicated that, whereas endorsing external forms of locus of control can be detrimental to the psychological well-being of urban breast cancer patients, the same is not true for rural breast cancer patients. For rural breast cancer patients, powerful others locus of control was beneficial for and chance locus of control was unrelated to well-being. CONCLUSIONS: Implications for future research and medical care are discussed.

Stigma Consciousness Modulates Cortisol Reactivity to Social Stress in Women.

The aim of the current study was to examine whether stigma consciousness shapes cortisol responses to social stress among women in the lab. Undergraduate women (N = 45) completed background measures and then participated in a public speaking task, with assessments of cortisol prior to the stressor as well as 20- and 40-minutes post stressor onset. Results from multilevel models revealed that women higher in stigma consciousness evidenced blunted cortisol reactivity following social stress across the study session compared to women lower in stigma consciousness. This interaction was robust to adjustment for a number of covariates, including demographic (e.g., age), physiological (e.g., menstrual cycle) and psychological (e.g., depressive symptomatology) factors. Potential explanations for observed cortisol patterns are discussed, including hypo-reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and elevated anticipatory stress. To conclude, implications for health disparities research are considered.

Perceived Discrimination and Social Relationship Functioning among Sexual Minorities: Structural Stigma as a Moderating Factor.

Work on structural stigma shows how public policy affects health outcomes for members of devalued groups, including sexual minorities. In the current research, structural stigma is proposed as a moderating variable that strengthens deleterious associations between perceived discrimination and social relationship functioning. Hypotheses were tested in two cross-sectional studies, including both online (N = 214; Study 1) and community (N = 94; Study 2) samples of sexual minority men and women residing throughout the United States. Structural stigma was coded from policy related to sexual minority rights within each state. Confirming hypotheses, support for the moderating role of structural stigma was found via multilevel models across studies. Specifically, associations between perceived discrimination and friendship strain, loneliness (Study 1) and familial strain (Study 2) were increased for those who resided in states with greater levels of structural stigma and attenuated for those who resided in states with lesser levels. In Study 1, these results were robust to state-level covariates (conservatism and religiosity), but conservatism emerged as a significant moderator in lieu of structural stigma in Study 2. Results are discussed in the context of the shifting landscape of public policy related to sexual minority rights within the United States.

Social Stigma and Sexual Minorities' Romantic Relationship Functioning: A Meta-Analytic Review.

To bolster knowledge of determinants of relationship functioning among sexual minorities, the current meta-analysis aimed to quantitatively review evidence for the association between social stigma and relationship functioning as well as examine potential moderators. Thirty-five studies were identified, including 130 effect sizes (39 independent; N = 10,745). Across studies, evidence was found for a small but significant inverse association between social stigma and relationship functioning. Furthermore, this association was moderated by stigma type (with more deleterious associations for internalized relative to perceived stigma) and dimension of relationship functioning (with more deleterious associations for affective relative to cognitive and negative relative to positive). Evidence for demographic moderators (region, sex, race, age) was generally mixed although important limitations related to unique characteristics of study samples are discussed. We conclude by highlighting the importance of social stigma for relationship functioning and point toward directions for future research and policy action.

Sex differences in cardiovascular health: does sexism influence women's health?

This commentary provides a brief overview of theory and research that supports the idea that sexism may be related to the disproportionate negative cardiovascular health outcomes in women. It describes sexism as a stressor and outlines its association with a variety of health outcomes as evidence for why sex disparities should be examined within the context of pervasive inequities. To date, population-based studies have not explicitly examined the relationship between sexism and cardiovascular disease, but smaller studies have yielded fairly consistent results. It is suggested that future research should aim to examine the influence of 2 types of sexism (ie, hostile and benevolent) and that daily or within-day designs be used to assess cognitive, behavioral and physiological responses to everyday sexist experiences.

Social roles, basic need satisfaction, and psychological health: the central role of competence.

The authors propose that competence need fulfillment within valued role domains (i.e., spouse, parent, worker) will account, in part, for associations between autonomy and relatedness need fulfillment and psychological health. Testing these assertions in cross-sectional and longitudinal surveys of women in two independent community samples, the findings are the first to formally examine whether the satisfaction of competence needs within social roles accounts for associations between other types of need satisfaction and affective outcomes as well as depressive symptomology. Evidence supporting the hypothesis was stronger when examining individuals' affective health as compared to their depressive symptoms. Implications of the findings are discussed with regard to need fulfillment within social roles.

Predictors of depressive symptoms among breast cancer patients during the first year post diagnosis.

It is important to identify predictors of psychological health among breast cancer patients that can be relatively easily identified by medical care providers. This article investigates the role of one class of such potential predictors: easily identified demographics that have potential social and/or practical implications. Specifically, we examined whether income, marital status, presence of children in the home, education, travel distance, age and rurality interact with time to predict psychological health over the first year post diagnosis. Two hundred and twenty five breast cancer patients receiving radiation treatment completed four surveys over the course of 13 months that included measures of both their physical health and depressive symptoms. The results revealed that women who were not married had children living in the home or had to travel long distances to receive radiation treatment reported higher levels of depressive symptoms across the entire study. Women with lower incomes reported increased depressive symptoms, but only after the completion of treatment. Younger women reported elevated depressive symptoms during initial treatment, but this effect dissipated after the completion of treatment. The current results suggest that demographic patient characteristics may indeed be useful in identifying both when and for whom depressive symptoms are particularly likely to be problematic.

The influence of breast cancer survivors' perceived partner social support and need satisfaction on depressive symptoms: a longitudinal analysis.

The present study examines the ways in which breast cancer survivors' perceptions of emotional and instrumental social support from an intimate partner and need satisfaction in their partner role influence depression during and after breast cancer treatment. Our sample was comprised of 163 women who were an average of 57 years old, mostly White/Caucasian, and diagnosed primarily with early-stage breast cancer. Longitudinal data were analysed using both multilevel and structural equation modelling. Results reveal that (a) greater perceived partner emotional support is associated with lowered levels of depression at each wave, (b) partner-role need satisfaction mediates the relationship between perceived partner emotional support and depression at each wave, (c) perceived partner emotional support predicts subsequent changes in depression by way of need satisfaction and (d) depression prospectively predicts lowered perceptions of partner emotional and instrumental support. The findings confirm that basic need satisfaction, within intimate relationships, is an important predictor of lowered depression among breast cancer survivors.

The feasibility and effectiveness of expressive writing for rural and urban breast cancer survivors.

PURPOSE/OBJECTIVES: To determine the feasibility and effectiveness of implementing an in-home expressive-writing intervention among breast cancer survivors living in urban and rural areas. DESIGN: Women who had completed radiation therapy were selected to participate in either expressive writing or a usual-care control condition. SETTING: All materials were completed in the privacy of participants' homes. SAMPLE: Of the 57 breast cancer survivors recruited, 40 participated in the writing intervention. An additional 40 women were assigned to the control group. METHODS: Participants completed measures of physical and psychological health at two time points prior to writing and at two follow-up time points three and nine months after writing. MAIN RESEARCH VARIABLES: Participation rates and physical and psychological health. FINDINGS: Results showed that engaging in a single in-home writing session for women with breast cancer was feasible and showed significant improvements in physical and psychological health compared to control three months (but not nine months) after writing. Although no difference was found in effectiveness of the intervention between women living in urban versus rural areas, rural women showed slightly higher participation rates. CONCLUSIONS: The results illustrate the utility of employing remotely administered expressive-writing interventions for breast cancer survivors. IMPLICATIONS FOR NURSING: Healthcare professionals who wish to use writing to facilitate improvements in their patients may suggest that patients write at multiple time points, offer for the intervention to be completed at home, and target rural populations in particular.

Rural breast cancer patients, coping and depressive symptoms: a prospective comparison study.

Many studies have revealed that individual differences in coping responses to the diagnosis and treatment of breast cancer are associated with psychological adjustment. The vast majority of these studies, however, focus exclusively on urban breast cancer survivors despite that rural breast cancer survivors are likely to have distinct experiences both in general and in relation to breast cancer. The current study quantitatively examined the coping strategies employed by both rural and urban breast cancer patients while they were undergoing radiation therapy. Further, the influence of these coping behaviours on concurrent as well as subsequent depressive symptoms (3 and 6 months later) was examined. The results revealed that the rurality of breast cancer patients was unrelated to the ways in which they coped, but did influence the relationships between some coping responses and depressive symptoms. Specifically, active coping and positive reinterpretation were negatively related to depressive symptoms for more rural breast cancer patients, but not their relatively urban counterparts. Similarly, behavioural disengagement was more strongly related to depressive symptoms for more rural patients. Possible reasons for this pattern of results and implications are discussed.

Satisfaction with health care, psychological adjustment, and community esteem among breast cancer survivors.

The present survey study examines whether satisfaction with health care predicts breast cancer patients' psychological adjustment and esteem for their communities. Forty-nine women undergoing radiation therapy for breast cancer completed measures of satisfaction with health care, psychological well-being, community esteem, depression, perceived health status, and demographics. As predicted, the results showed that breast cancer survivors' satisfaction with their health care was predictive of their psychological well-being even when controlling for relevant variables such as depression and health status. Also, breast cancer survivors' satisfaction with their health care predicted their level of community esteem. These findings are discussed in terms of their implications for the psychological adjustment of breast cancer survivors.

The breast cancer experience of rural women: a literature review.

This report is a review of studies that focus on rural breast cancer survivorship. It includes a total of 14 studies using large databases and 27 other studies using qualitative and quantitative methods. In our review of this literature, we identified four broad themes, including access to treatment and treatment type, medical providers and health information, psychosocial adjustment and coping, and social support and psychological support services. We review the findings of the rural breast cancer survivorship studies within each of these broad themes. A few of the findings of the review include that rural and urban women receive different primary treatments for breast cancer, that rural women may have greater difficulty negotiating their traditional gender roles during and after treatment, that rural women desire greater health-related information about their breast cancer, and that rural women have less access to mental health therapy. The review discusses the implications of these findings as well as the weakness in the literature.