Psychological and clinical correlates of posttraumatic growth in cancer: A systematic and critical review.

OBJECTIVE: The objective of this study is to describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main psychological and clinical correlates. METHODS: A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus, and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, abstract, and full text. RESULTS: Seventy-two met the inclusion criteria. Most articles (46%) focused on breast cancer, used the PTG inventory (76%), and had a cross-sectional design (68%). The PTG resulted inversely associated with depressive and anxious symptoms and directly related to hope, optimism, spirituality, and meaning. Illness-related variables have been poorly investigated compared to psychological ones. Articles found no relationship between cancer site, cancer surgery, cancer recurrence, and PTG. Some correlations emerged with the elapsed time since diagnosis, type of oncological treatment received, and cancer stage. Only few studies differentiated illness-related-life-threatening stressors from other forms of trauma, and the potentially different mechanisms connected with PTG outcome in cancer patients. CONCLUSIONS: The evaluation of PTG in cancer patients is worthy, because it may promote a better adaption to the illness. However, many investigations do not explicitly refer to the medical nature of the trauma, and they may have not completely captured the full spectrum of positive reactions in cancer patients. Future research should better investigate issues such as health attitudes; the risks of future recurrences; and the type, quality, and efficacy of medical treatments received and their influence on PTG in cancer patients.

Dietary exposure levels to polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and non-ortho-polychlorinated biphenyls in US meat, poultry and siluriform fish from 2018 to 2019.

Daily dietary exposure estimates from beef, pork, chicken, turkey and siluriform fish were calculated using toxic equivalency (TEQ) data from the U.S. Department of Agriculture's survey of dioxins and dioxin-like compounds (DLCs) in the domestic meat supply and consumption data. Exposure estimates for the whole population and age groups were based on mean consumption of a commodity and mean or 90th percentile TEQ dioxin levels from the survey. Ratios of the exposure estimates to the U.S. EPA oral reference dose (RfD) of 0.7 pg TEQ/kg bw/day were calculated to determine if domestic meat might contribute materially to consumer exposure. In general, normal consumption of lean beef, pork, chicken and turkey will not cause exposures exceeding the RfD. Non-lean meats will have higher dioxin levels as dioxins accumulate in fat, therefore consumption of non-lean meat might cause higher exposure than compared to lean meat. However, on a mean basis, none of the exposure estimates for non-lean beef, pork, chicken or turkey exceeded the RfD for any of the age groups. For some age groups, especially toddlers, there are commodities such as non-lean beef in the 90th percentile of dioxin TEQs and siluriform fish that might exceed the RfD on occasion.

Impact of rainfed agriculture on spatio-temporal patterns of water balance and the interaction between groundwater and surface water in sub-humid plains.

The expansion of rainfed agriculture, especially soybean cultivation in sub-humid plains, alters water balance and the exchange between groundwater-surface water (GW-SW). However, to date, there are no studies that analyze how these anthropic disturbances affect hydrological connectivity in these systems, especially the GW-SW interactions. The objective of this study is to analyze how the increase in rainfed agriculture affects the spatio-temporal patterns of the water balance and the GW-SW interaction. For this analysis, a coupled GW-SW flow model was implemented under land use and land cover (LULC) scenarios, to quantify the spatio-temporal dynamics for different components of water balance and GW-SW interactions for the upper creek basin of Del Azul. A simulation was carried out for a period of 13 years (2003-2015) on a daily scale and it was contrasted through three multitemporal LULC maps. The results point that substitution of natural pastures, the reduction of winter crops and the decrease of crop rotation, due to the increase of soybean monoculture in the basin under study, modifies the water balance, especially the annual rates of surface runoff and soil moisture which may increase between 3.5 and 9.4 % and between 1.4 and 4.4 % respectively, thus increasing the annual streamflows between 2.6 and 6.8 % and the groundwater heads between 0.2 and 0.6 m. This leads to changes in the hetereogeneity of the GW-SW interaction, a reduction between 0.3 and 3 % is observed in the discharge from the Pampeano aquifer to the Del Azul stream, while the recharge rates from the Del Azul stream to the Pampeano aquifer increase between 2 and 17.8 %. The application of the SWAT-MODFLOW model under LULC scenarios, improves the prediction of the regional hydrologic connectivity on sub-humid plains, because the hydrological processes occurring in the surface and non-saturated zone are governed by shallow groundwater dynamics.

Decision-making deficits in pathological gambling: the role of executive functions, explicit knowledge and impulsivity in relation to decisions made under ambiguity and risk.

BACKGROUND: A variety of cognitive and emotional processes influence the decision-making deficits observed in pathological gambling (PG). This study investigated the role of immediate/delayed sensitivity to reward and punishment, executive functions, impulsivity and explicit knowledge in relation to decision-making performance on the original Iowa Gambling Task (IGT-ABCD) and a variant (IGT-EFGH). METHODS: We assessed 131 consecutive patients with a diagnosis of PG by using executive functioning and decision-making tasks, self-report measures of impulsivity and explicit knowledge. RESULTS: The majority of pathological gamblers (PGs) showed deficits in decision-making, characterized mainly by myopia for the future. Decisions made under risk showed different predictors. Performance on the IGT-ABCD for decisions made under risk was predicted by medium and high levels of explicit knowledge of the task, as well as by scores on the Disorderliness subscale and the degree of Stroop interference. By contrast, IGT-EFGH results were only associated with self-report impulsivity measures. CONCLUSIONS: Decision making in PG involves distinct patterns of deficits, and the predictors differ depending on the reinforcement schedule. Decisions made under risk on the IGT-ABCD are associated with explicit knowledge, executive functions and impulsivity traits related to conscious awareness and control processes. On the IGT-EFGH, however, only impulsivity traits predict decision making.

Modifications to a Biphenolic Antibacterial Compound: Activity against ESKAPE Pathogens.

Forty-four analogs of honokiol, a compound with known antibacterial activity, especially with respect to oral bacteria, were synthesized to explore the structure-activity relationships against the ESKAPE pathogens. Compounds with high therapeutic indices (hemolysis20 /MIC) were identified. In particular, ester-linked compounds that would be less than environmentally durable than biaryl ether antibacterials such as the broadly used triclosan were found to be active. MRSA mutants could be generated against some, but not all, of the highly active compounds. Based on gene sequencing results, membrane permeability, intracellular sodium, and intracellular pH assays revealed overlapping mechanisms of action.

Survey of polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and non-ortho-polychlorinated biphenyls in U.S. meat, poultry, and siluriform fish from 2018-2019: toxic equivalency levels, temporal trends, and implications.

The U.S. Department of Agriculture (USDA) conducted a survey of domestic animal products including beef fat, pork fat, chicken fat, turkey fat, dairy cow fat, and siluriform fish muscle (i.e. catfish) to determine the current residue levels of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and non-ortho-polychlorinated biphenyls (no-PCBs). The following types of fat samples were analysed: beef from heifers and steers (referred to as "beef"), pork, chicken, turkey, dairy cow (referred to as "dairy cow"), and siluriform fish muscle, which includes catfish. The survey is conducted every 5 years. Fat samples for each slaughter class and siluriform fillets were collected from U.S. federally inspected slaughter facilities, processed, and analysed for 17 PCDD/Fs and 3 no-PCBs. Toxic equivalency concentrations were calculated using 2005 toxic equivalency factors and summed (sum-TEQ) for all slaughter classes. The sum-TEQs ranged from non-detect (nd) to 16.5 pg TEQ/g lipid. The median sum-TEQs, when nd = ½ LOD, for beef, pork, chicken, turkey, dairy cow, and siluriform fish were 0.48, 0.08, 0.07, 0.21, 0.38, and 0.62 pg TEQ/g lipid (wet weight for siluriform fish), respectively. A comparison of the current and previous surveys typically depicts a significant declining trend depending on the slaughter class (such as chicken and turkey), however, beef and pork fat median values slightly increased and decreased, respectively, but neither were significant compared to the previous survey. The congener patterns for some high concentration beef and pork fat samples suggested that pentachlorophenol treated wood continues to be a likely on-farm dioxin exposure source.

Modification of Biphenolic Anti-Bacterial to Achieve Broad-Spectrum Activity.

The Gram-positive bacteria, methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative bacteria, Acinetobacter baumannii, are pathogens responsible for millions of nosocomial infections worldwide. Due to the threat of bacteria evolving resistance to antibiotics, scientists are constantly looking for new classes of compounds to treat infectious diseases. The biphenolic analogs of honokiol that were most potent against oral bacteria had similar bioactivity against MRSA. However, all the compounds proved ineffective against A. baumannii. The inability to inhibit A. baumannii is due to the difficult-to-penetrate lipopolysaccharide-coated outer membrane that makes it challenging for antibiotics to enter Gram-negative bacteria. The C 2 scaffold was optimized from the inhibition of Gram-positive bacteria to broad-spectrum antibacterial compounds that inhibit the dangerous Gram-negative pathogen A. baumannii.

Work schedule flexibility and teleworking were not good together during COVID-19 when testing their effects on work overload and mental health.

The COVID-19 pandemic has driven organizations to implement various flexible work arrangements. Due to a lack of longitudinal studies, there is currently no consensus in specialized literature regarding the consequences of flexible work arrangements on employee mental health, as well any long term potential impacts. Using the Job Demand-Resource Model, this study documents consequences of the implementation of two types of flexible work arrangement: work schedule flexibility and teleworking on employee mental health over time, and the mediating role played by work overload during the accelerated implementation of flexible work arrangements in the course of the COVID-19 pandemic. Using a longitudinal design and probabilistic sampling, 209 workers participated in this study, twice answering a flexible work arrangement and mental health questionnaire during the pandemic. Findings of this moderated-mediation suggest that work schedule flexibility generates positive effects on mental health over time due to decreased work overload, but only for employees not working from home. These results offer theoretical and practical implications applicable to organizations considering implementation of flexible work arrangements, particularly with regard to how these flexible practices could support a balance between demand and resources, their impact on work overload, and employee mental health over time.

Everything causes cancer? Beliefs and attitudes towards cancer prevention among anti-vaxxers, flat earthers, and reptilian conspiracists: online cross sectional survey.

OBJECTIVE: To evaluate, using an online non-probability sample, the beliefs about and attitudes towards cancer prevention of people professing vaccination scepticism or conspiracy theories. DESIGN: Cross sectional survey. SETTING: Data collected mainly from ForoCoches (a well known Spanish forum) and other platforms, including Reddit (English), 4Chan (English), HispaChan (Spanish), and a Spanish language website for cancer prevention (mejorsincancer.org) from January to March 2022. PARTICIPANTS: Among 1494 responders, 209 were unvaccinated against covid-19, 112 preferred alternative rather than conventional medicine, and 62 reported flat earth or reptilian beliefs. MAIN OUTCOME MEASURES: Cancer beliefs assessed using the Cancer Awareness Measure (CAM) and Cancer Awareness Measure Mythical Causes Scale (CAM-MYCS) (both validated tools). RESULTS: Awareness of the actual causes of cancer was greater (median CAM score 63.6%) than that of mythical causes (41.7%). The most endorsed mythical causes of cancer were eating food containing additives or sweeteners, feeling stressed, and eating genetically modified food. Awareness of the actual and mythical causes of cancer among the unvaccinated, alternative medicine, and conspiracy groups was lower than among their counterparts. A median of 54.5% of the actual causes was accurately identified among each of the unvaccinated, alternative medicine, and conspiracy groups, and a median of 63.6% was identified in each of the three corresponding counterparts (P=0.13, 0.04, and 0.003, respectively). For mythical causes, medians of 25.0%, 16.7%, and 16.7% were accurately identified in the unvaccinated, alternative medicine, and conspiracy groups, respectively; a median of 41.7% was identified in each of the three corresponding counterparts (P<0.001 in adjusted models for all comparisons). In total, 673 (45.0%) participants agreed with the statement "It seems like everything causes cancer." No significant differences were observed among the unvaccinated (44.0%), conspiracist (41.9%), or alternative medicine groups (35.7%), compared with their counterparts (45.2%, 45.7%, and 45.8%, respectively). CONCLUSIONS: Almost half of the participants agreed that "It seems like everything causes cancer," which highlights the difficulty that society encounters in differentiating actual and mythical causes owing to mass information. People who believed in conspiracies, rejected the covid-19 vaccine, or preferred alternative medicine were more likely to endorse the mythical causes of cancer than their counterparts but were less likely to endorse the actual causes of cancer. These results suggest a direct connection between digital misinformation and consequent erroneous health decisions, which may represent a further preventable fraction of cancer.

Effect of executive functioning, decision-making and self-reported impulsivity on the treatment outcome of pathologic gambling.

BACKGROUND: Impairments in self-regulatory behaviour reflect a deficit in executive functioning and decision-making, as well as higher levels of self-reported impulsivity, and may be involved in the development and maintenance of addictive disorders. We sought to explore the association between self-reported impulsivity and neurocognitive measures, and their association with treatment outcome in pathologic gambling. METHODS: We assessed patients with pathologic gambling using executive functioning and decision-making tests and self-report measures of impulsivity. Patients underwent cognitive-behavioural therapy (CBT) for pathologic gambling. RESULTS: We included 88 patients (8% women) in our study. High self-reported extravagance was associated with poor performance in the Iowa Gambling Task (IGT)-ABCD version. High impulsiveness, low disorderliness, high exploratory excitability (trend), poor backward block span and poor IGT-EFGH scores (trend) predicted dropout. We observed no self-reported or neurocognitive predictors of relapse or number of treatment sessions attended. LIMITATIONS: Most participants were slot-machine gamblers seeking treatment. No follow-up data and no control group were included in the study. The missing sample (i.e., individuals who were recruited and assessed in the pretreatment stage but who chose not to begin treatment) had higher extravagance scores than the final sample. CONCLUSION: Neurocognitive reward sensitivity was related to self-reported overspending behaviour. Self-regulatory impairments (especially rash impulsiveness and punishment sensitivity) and executive dysfunction predicted only dropout of CBT in participants with pathologic gambling. Different neurocognitive processes and personality traits might mediate treatment response to psychological therapy of pathologic gambling according to the specific target variable assessed.

Use of Telehealth for Domiciliary Follow-up After Hematopoietic Cell Transplantation During the COVID-19 Pandemic: Prospective Pilot Study.

BACKGROUND: Patients who have recently received a hematopoietic cell transplant (HCT) are at higher risk of acute complications in the first weeks after discharge, especially during the COVID-19 pandemic. OBJECTIVE: The aim of this study was to test the use of a telehealth platform for the follow-up of HCT patients during the first two weeks after discharge. METHODS: In total, 21 patients who received autologous or allogeneic HCT for hematological malignancies were screened from April 30, 2020, to July 15, 2020. The telehealth platform assisted in the daily collection of vital signs as well as physical and psychological symptoms for two weeks after hospital discharge. The required medical devices (oximeter and blood pressure monitor) were given to patients and a dedicated smartphone app was developed to collect this data. The data were reviewed daily through web-based software by a hematologist specializing in HCT. RESULTS: Only 12 of 21 patients were able to join and complete the study. Technological barriers were the most frequent limiting factor in this study. Among the 12 patients who completed the study, adherence to data reporting was high. The patients' experience of using such a system was considered good. In two cases, the system enabled the early recognition of acute complications. CONCLUSIONS: This pilot study showed that telehealth systems can be applied in the early posttransplant setting, with evident advantages for physicians and patients for both medical and psychological aspects. Technological issues still represent a challenge for the applicability of such a system, especially for older adult patients. Easier-to-use technologies could help to expand the use of telehealth systems in this setting in the future.

Spatio-temporal effect of climate change on water balance and interactions between groundwater and surface water in plains.

The analysis of the impact of climate change on water resources in plains requires integral simulation tools that quantify topographic complexity and the strong interaction of groundwater and surface water components (GW-SW). The objective of this study is to implement a coupled hydrological-hydrogeological model under climate change scenarios in order to quantify the spatio-temporal dynamics of water balance and GW-SW interactions for the upper creek basin of Del Azul, which is located in the center of the province of Buenos Aires. The simulation was carried out for a baseline scenario calibrated and validated for the period 2003-2015 and contrasted with two scenarios of the regional climate model CCSM4, RCP (4.5 and 8.5) simulated for the period 2020-2050. First, the annual and monthly anomalies of precipitation, temperature, surface runoff, evapotranspiration, soil moisture, recharge, flow, as well as the discharge, head level and reserves of groundwater are studied. Then the spatio-temporal anomalies of the GW-SW interaction were analyzed and finally wet and dry periods by means of the standardized precipitation index and the annual water balance were studied. Simulation results show that climate change will significantly alter the spatio-temporal patterns of the GW-SW interaction as well as the water balance. These showed monthly, seasonal and annual variations. They show an increase in most of the components of the water balance towards the middle of the 21st century, except soil moisture. Regarding GW-SW interactions, the average annual discharge of the aquifer to the stream is expected to increase by 5% with RCP 4.5 while it will increase 24% with RCP 8.5. The recharge from the stream to the aquifer is expected to increase by 12% with RCP 4.5 while a decrease by 5% with RCP 8.5. Concerning the SPI related to the water balance for the period 2020-2050, alternations of both the time and the length of dry and wet periods are expected for the two scenarios, with RCP 4.5 low frequency of wet episodes, but with a greater severity and permanence in time in contrast to RCP 8.5 that presents less frequency in dry periods, but with high permanence and severity. Climate change could alter groundwater mainly through changes in the recharge, leading to modify groundwater levels and this will cause GW-SW flow to be reversed in some sectors of the stream by increasing or decreasing groundwater discharge into the stream.

A Bisphenolic Honokiol Analog Outcompetes Oral Antimicrobial Agent Cetylpyridinium Chloride via a Membrane-Associated Mechanism.

Targeting Streptococcus mutans is the primary focus in reducing dental caries, one of the most common maladies in the world. Previously, our groups discovered a potent bactericidal biaryl compound that was inspired by the natural product honokiol. Herein, a structure activity relationship (SAR) study to ascertain structural motifs key to inhibition is outlined. Furthermore, mechanism studies show that bacterial membrane disruption is central to the bacterial growth inhibition. During this process, it was discovered that analog C2 demonstrated a 4-fold better therapeutic index compared to the commercially available antimicrobial cetylpyridinium chloride (CPC) making it a viable alternative for oral care.

Honokiol-Inspired Analogs as Inhibitors of Oral Bacteria.

The oral microbiome is a complex ecological niche where both commensal and pathogenic bacteria coexist. Previous reports have cited that the plant isolate honokiol is a potent inhibitor of S. mutans biofilms. Herein we report a cross-coupling method that provides access to a concise library of honokiol-inspired analogs. Through this work we determined that the inhibitory activity of honokiol is highly dependent on the growth conditions. Further, we identify a series of analogs that display significant potency against oral bacteria leading to the discovery of a potent antimicrobial.

Positive psychotherapy for distressed cancer survivors: Posttraumatic growth facilitation reduces posttraumatic stress.

There is increasing evidence that positive life changes, such as posttraumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months' follow-up. Participants' PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.

ANTECEDENTES/OBJETIVO: La evidencia científica muestra la importante presencia de cambios vitales positivos, como el crecimiento postraumático (CPT), tras afrontar un cáncer. Sin embargo, ninguna intervención ha sido específicamente diseñada para facilitar el CPT en pacientes con cáncer. En este artículo, se describen y evalúan los resultados de la Psicoterapia Positiva dirigida a supervivientes de Cáncer (PPC), diseñada para facilitar el CPT como vía para reducir el malestar emocional y estrés postraumático. Utilizamos indicadores interpersonales para validar la autenticidad del CPT. Método: Ciento veintiséis supervivientes de cáncer con elevados niveles de malestar emocional fueron consecutivamente asignados al grupo experimental (PPC) o al grupo de lista de espera. Resultados: El grupo de PPC obtuvo significativamente mejores resultados después del tratamiento que el grupo control, mostrando una reducción del malestar psicológico, de los síntomas de estrés postraumático y un incremento del CPT. Los beneficios se mantuvieron a los 3 y 12 meses. El CPT fue corroborado por los seres queridos de los participantes. Conclusiones: La PPC parece promover de forma significativa el CPT y reduce el malestar emocional y el estrés postraumático en supervivientes de cáncer. Además, la facilitación de CPT inducido por la PPC es corroborada por los seres queridos.

Positive psychological functioning in breast cancer: An integrative review.

This integrative review aimed to analyze the research into positive psychological functioning after breast cancer, and to integrate the most relevant findings relating to sociodemographic, medical and psychosocial factors. Relevant outcomes were identified from electronic databases (Medline, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, and Wiley Online Library) up to July 2015. A Google search was performed to identify unindexed literature. Dissertations and theses were searched on Proquest Dissertations and Theses, DIALNET and TDX. Selection criteria included empirical studies assessing relationships between breast cancer and positive functioning, without restrictions on type of participants. In total, 134 studies met the inclusion criteria. The sociodemographic, medical, and psychosocial characteristics associated with well-being, posttraumatic growth, finding benefit and meaning were being young, undergoing chemotherapy, and having social support. The last two of these characteristics were time-oriented. The culture of the different samples and positive dispositional characteristics like optimism had an influence on the women's coping styles. Socioeconomic status and level of education were also associated with positive psychological functioning. The perceived impact of breast cancer on patient, as well as the perceived support from significant others can result in better functioning in women with breast cancer. The results highlight that oncology health professionals should take into account not only the individual and medical characteristics, but also the stage of the oncological process and the psychosocial environment of patients in order to promote their positive functioning.

[Cultural scale adaptation and validation of the Spanish version of the BRCA Self-Concept Scale in women carriers at high risk for hereditary breast and ovarian cancer]. / Adaptación cultural y validación de la versión española de la Escala de Autoconcepto en BRCA en mujeres portadoras con alto riesgo de cáncer de mama y ovario hereditario.

BACKGROUND AND OBJECTIVE: Having an inherited predisposition to cancer may have a psychological impact, and one goal of genetic counseling is to promote psychological adjustment to the new situation. Thus, in the genetic context, validated measures of adjustment are required. Given that self-concept is a good indicator of adjustment to the disease or to the risk for it, and a relevant variable in oncology, the goal of the study is to culturally adapt and validate the BRCA Self-Concept Scale. MATERIAL AND METHOD: One hundred and sixty-five BRCA carriers' women answered to the questionnaire, previously adapted through a process of forward/back-translation, and to the Cancer Worry Scale (CWS) as a measure of convergent validity. Theoretical structure of BRCA Self-Concept Scale was assessed by expert judges, and submitted to a confirmatory factor analysis (CFA). Cronbach's α was calculated for each subscale (Stigma, Vulnerability and Control), and correlations with CWS were performed. RESULTS: Expert judges' structure and CFA do not support the original structure of the questionnaire. The respecificity model (with items 10 and 13 loading on Vulnerability factor) show a better fit: comparative fit index 0.973; Tucker-Lewis index 0.968; root mean square error of approximation 0.067. The Cronbach's α is 0.83 for Stigma, 0.84 for Vulnerability, and 0.61 for Control. Evidence of convergent validity with CWS has been obtained (Spearman's rho 0.631 for Stigma, 0.683 for Vulnerability, and -0.363 for Control; P<.001). CONCLUSIONS: Results support the validity of the modified Spanish BRCA Self-Concept Scale, which is a potentially useful measure for the study of psychological adjustment to high risk for hereditary breast and ovarian cancer.

Decision Making Impairment: A Shared Vulnerability in Obesity, Gambling Disorder and Substance Use Disorders?

INTRODUCTION: Addictions are associated with decision making impairments. The present study explores decision making in Substance use disorder (SUD), Gambling disorder (GD) and Obesity (OB) when assessed by Iowa Gambling Task (IGT) and compares them with healthy controls (HC). METHODS: For the aims of this study, 591 participants (194 HC, 178 GD, 113 OB, 106 SUD) were assessed according to DSM criteria, completed a sociodemographic interview and conducted the IGT. RESULTS: SUD, GD and OB present impaired decision making when compared to the HC in the overall task and task learning, however no differences are found for the overall performance in the IGT among the clinical groups. Results also reveal some specific learning across the task patterns within the clinical groups: OB maintains negative scores until the third set where learning starts but with a less extend to HC, SUD presents an early learning followed by a progressive although slow improvement and GD presents more random choices with no learning. CONCLUSIONS: Decision making impairments are present in the studied clinical samples and they display individual differences in the task learning. Results can help understanding the underlying mechanisms of OB and addiction behaviors as well as improve current clinical treatments.

Dopamine DRD2/ANKK1 Taq1A and DAT1 VNTR polymorphisms are associated with a cognitive flexibility profile in pathological gamblers.

Like drug addiction, pathological gambling (PG) has been associated with impairments in executive functions and alterations in dopaminergic functioning; however, the role of dopamine (DA) in the executive profile of PG remains unclear. The aim of this study was to identify whether the DRD2/ANKK1 Taq1A-rs1800497 and the DAT1-40 bp VNTR polymorphisms are associated with cognitive flexibility (measured by Wisconsin Card Sorting Test (WCST) and Trail Making Test (TMT)) and inhibition response (measured by Stroop Color and Word Test (SCWT)), in a clinical sample of 69 PG patients. Our results showed an association between DA functioning and cognitive flexibility performance. The Taq1A A1+ (A1A2/A1A1) genotype was associated with poorer TMT performance (p<0.05), while DAT1 9-repeat homozygotes displayed better WCST performance (p<0.05) than either 10-repeat homozygotes or heterozygotes. We did not find any association between the DRD2 or DAT1 polymorphisms and the inhibition response. These results suggested that pathological gamblers with genetic predispositions toward lower availability of DA and D2 receptor density are at a higher risk of cognitive flexibility difficulties. Future studies should aim to shed more light on the genetic mechanisms underlying the executive profile in PG.

Posttraumatic growth in cancer: reality or illusion?

Research in posttraumatic growth (PTG) among cancer patients has been triggered primarily by the inclusion of serious illnesses among the events that can lead to posttraumatic stress disorder (PTSD); increasing survival rates among cancer patients; and, attempts at encouraging a positive psychology that focuses on a patient's ability to fight adversity. The difficulties encountered in clearly defining the processes associated with this subjective feeling of growth following recovery raise doubts concerning the real or illusory nature of the phenomenon and its adaptative value. This paper explains why cancer may be different than other traumas and why PTG may interact with this ecology of circumstances in different ways. Difficulty in identifying a single stressor, the internal source of the event, cancer as a future, ongoing and chronic integration threat, and greater perceived control differences between cancer and others traumas. This review brings together the latest studies of PTG in cancer, and focuses in the debate of the real or illusory nature of the PTG and his adaptative value. The ongoing threat, uncertainty and vulnerability associated with cancer are the variables that have been related most consistently with PTG and tend to confuse the relationship between PTG and emotional well-being, too.