How does a single session group intervention improve sexual function in ovarian cancer survivors? A secondary analysis of effects of self-efficacy, knowledge and emotional distress.

Although sexual dysfunction after ovarian cancer (OC) treatment is a common side effect, intervention for this issue remains largely unaddressed in the literature. To address this gap, we recently developed and tested a theory-driven psychosexual intervention that successfully improved sexual function in OC survivors. This study is a secondary analysis to determine whether the intervention effects were consistent with our theoretical model. We expected that improved self-efficacy, sexual knowledge and emotional distress would relate to improved sexual function, and that effects of sexual knowledge and self-efficacy on sexual function would be mediated by emotional distress. 46 OC survivors completed study measures prior to and two-months following the intervention. Results indicated that self-efficacy, sexual knowledge, and emotional distress improved significantly post-intervention. While self-efficacy and emotional distress were both directly associated with sexual function; contrary to expectation, change in knowledge was not. Results also demonstrated that the relationship between self-efficacy and sexual function was not mediated by emotional distress. Clinical implications underscore the importance of promoting self-efficacy and decreasing emotional distress in the context of sexual rehabilitation treatment for OC survivors. Next steps include refining the intervention based on these findings and testing in a larger, randomized trial of gynecological cancer survivors.

Self-Image and Sexuality Issues among Young Women with Breast Cancer: Practical Recommendations.

BACKGROUND: Younger breast cancer survivors face a unique set of treatment-related issues that have enormous impact on quality of life and psychological well-being. Although there is often a profound and distressing impact of treatment on self-image and sexual function, women rarely receive any attention for these issues. Unfortunately, most clinicians receive no training on how to inquire about these problems and most clinicians feel unprepared to discuss them. Often this silence is due to a lack of ready resources and uncertainty of appropriate strategies for rehabilitation. Cultural barriers may also contribute to lack of attention to these issues. OBJECTIVE: The aim of this paper is to not only elucidate common problems regarding self-image and sexual dysfunction, but to also offer concrete guidance about inquiry using a simple checklist approach as well as tips for resources and other evidence-based intervention strategies. Samples of a checklist and resource sheet for women written in Spanish are included, and cultural considerations within a Hispanic/Latina framework will be noted. As the great majority of young breast cancer patients are now becoming long-term survivors, it is essential for clinicians to learn how to address distressing treatment-related late effects including diminished self-image and sexual dysfunction.

The relationship between alliance and outcome: Analysis of a two-person perspective on alliance and session outcome.

OBJECTIVE: Better alliance is known to predict better psychotherapy outcomes, but the interdependent and interactive effects of both therapist- and patient-reported alliance levels have yet to be systematically investigated. METHOD: Using actor-partner interdependence model analysis the authors estimated actor, partner, and 2 types of interactive effects of alliance on session outcome in a sample of 241 patient-therapist dyads across 30 sessions of cognitive-behavioral and alliance-focused therapy. RESULTS: Findings suggest that the most robust predictors of session outcome are within-treatment changes in patient reports of the alliance, which predict both patient and therapist report on outcome. Within-treatment changes in therapist reports of the alliance, as well as differences between patients and between therapists in their average ratings of alliance levels across treatment, predict outcome as reported by the specific individual. Although alliance was found to be a significant predictor of outcome in both treatments, for therapist-reported alliance and outcome it had a stronger effect in alliance-focused therapy than in cognitive-behavioral therapy. Additionally, dyads with the highest pooled level of alliance from both partners fared best on session outcome. CONCLUSIONS: The results are consistent with a 2-person perspective on psychotherapy, demonstrating the importance of considering the interdependent and interactive nature of both patient and therapist alliance levels on session outcome. (PsycINFO Database Record

Physical self-similarity enhances the gaze-cueing effect.

Important social information can be gathered from the direction of another person's gaze, such as their intentions and aspects of the environment that are relevant to those intentions. Previous work has examined the effect of gaze on attention through the gaze-cueing effect: an enhancement of performance in detecting targets that appear where another person is looking. The present study investigated whether the physical self-similarity of a face could increase its impact on attention. Self-similarity was manipulated by morphing participants' faces with those of strangers. The effect of gaze direction on target detection was strongest for faces morphed with the participant's face. The results support previous work suggesting that self-similar faces are processed differently from dissimilar faces. The data also demonstrate that a face's similarity to one's own face influences the degree to which that face guides our attention in the environment.