The Relevance of Assessing Subjective Experiences of Skin Toxicity During Adjuvant Radiotherapy for Breast Cancer.

PURPOSE: Radiodermatitis is likely to be an inevitable side effect of radiotherapy (RT) but experiencing pain relief during RT might contribute making treatment more acceptable and less impairing. The current study aimed to assess the subjective perceptions and experiences of skin toxicity in a sample of women undergoing adjuvant RT for breast cancer. METHODS: Eighty patients were randomly assigned to one out of two groups: treatment (i.e., a newly developed topical product) and control (i.e., standard-of-care). Patients underwent adjuvant RT for 3 weeks. Clinical assessment of radiodermatitis and self-reported levels of pain, relief, and perceptions of treatment response were collected at the initiation of RT (T1), during RT (T2 and T3), and 2 weeks after treatment completion (T4). To assess changes in skin-related QoL, a subgroup of patients completed the Padua Skin-Related QoL questionnaire at T0 (before the initiation of RT) and at T4. RESULTS: A comparable timing of onset and severity of radiodermatitis during treatment was observed in both groups. The treatment group reported lower levels of pain and higher levels of relief compared to the control group when skin toxicity was at its highest levels (T2 and T3). Independent of the group, levels of perceived improvements in clinical status increased over time, whereas skin-related QoL worsened from T0 to T4. CONCLUSION: Current findings outline the relevance of integrating clinical evaluations of radiodermatitis with patients' subjective experiences of skin toxicity in interventional studies. Moreover, they provide preliminary evidence about the soothing effect of a newly developed topical product, thus supporting its usefulness of as a supportive care.

Exploring Diener's Multidimensional Conceptualization of Well-Being Through Network Psychometrics.

Previous research has addressed the study of the well-being structure focusing on the separability among hedonic and eudaimonic dimensions by means of latent variable approaches. Diener's tripartite model of Subjective Well-Being has often been identified with hedonic well-being, while flourishing (i.e., positive functioning) has been classified as a proxy for eudaimonic well-being. Instead of pursuing a theory-driven approach, the structure of well-being dimensions can be retrieved by means of network psychometrics that is a highly informative, data-driven approach that allows the model structure to spontaneously emerge from the relationships among indicators. Furthermore, we propose a strength centrality decomposition that is able to summarize the influence of a specific indicator within its dimension and between the other dimensions. Contrary to the theoretical conjecture that the separability among well-being dimensions can be grounded on a hedonic and eudaimonic distinction, our results point to a categorization of the Diener's well-being indicators based on the type of information they convey, that is global evaluation of life satisfaction, positive and negative affective experiences, and perceived positive functioning in life.

Measuring cognitive vulnerability to depression: Further evidence on the factorial and predictive validity of negative cognitive style.

BACKGROUND AND OBJECTIVES: Previous research has provided insufficient evidence on the factorial validity of the negative cognitive style questionnaires, which is a problem for the validity of the total score's computation. In Study 1, we focused on the relationship between internality and the other dimensions of negative cognitive style. In Study 2, we explored the predictive validity of negative cognitive style for negative interpretation bias. METHODS: In Study 1, 770 participants completed the Cognitive Style Questionnaire - Short Form (CSQ-SF). In Study 2, from a prescreening data collection (N = 300) we selected participants with low (N = 40) and high (N = 32) cognitive vulnerability to depression who were primed with negative mood induction and who completed a generative interpretation task. RESULTS: In Study 1, a confirmatory factor analysis (CFA) indicated that the best fitting model for the CSQ-SF was a bifactor model without the internality dimension. In Study 2, a CFA replicated the factorial structure of Study 1 and individuals with a high negative cognitive style exhibited a negative interpretation bias after controlling for depressive symptoms. LIMITATIONS: The university-age sample limited the generalizability of our results to different populations, and the lack of longitudinal data prevented us from discussing further implications on the relationship between the negative interpretation bias and negative cognitive style in predicting depression. CONCLUSIONS: Together, the results of our two studies support the construct validity of the CSQ-SF and recommend the use of a composite score of negative cognitive style without internality.

Illness denial questionnaire for patients and caregivers.

PURPOSE: Interest in assessing denial is still present, despite the criticisms concerning its definition and measurement. We tried to develop a questionnaire (Illness Denial Questionnaire, IDQ) assessing patients' and caregivers' denial in relation to their illness/disturbance. PATIENTS AND METHODS: After a preliminary study, a final version of 24 dichotomous items (true/false) was selected. We hypothesized a theoretical model with three dimensions: denial of negative emotions, resistance to change, and conscious avoidance, the first two composing the actual Denial and the last representing an independent component of the illness denial behavior. The IDQ was administered to 400 subjects (219 patients and 181 caregivers) together with the Anxiety-Depression Questionnaire - Reduced form (AD-R), in order to assess concurrent validity. Confirmatory factor analysis (CFA), internal consistency indices (Cronbach's α and McDonald's ω), and test-retest analysis were performed. RESULTS: CFA and internal consistency indices (Cronbach's α: 0.87-0.96) indicated a clear and meaningful three-factor structure of IDQ, for both patients and caregivers. Further analyses showed good concurrent validity, with Denial and its subscale negatively associated with anxiety and depression and avoidance positively associated with anxiety and depression. The IDQ also showed a good stability (r from 0.71 to 0.87). CONCLUSION: The IDQ demonstrated good psychometric properties. Denial of negative emotions and resistance to change seem to contribute to a real expression of denial, and conscious avoidance seems to constitute a further step in the process of cognitive-affective elaboration of the illness.