Self-system therapy as an intervention for self-regulatory dysfunction in depression: a randomized comparison with cognitive therapy.

Self-system therapy (SST) is a new therapy based on regulatory focus theory (E. T. Higgins, 1997) for depressed individuals unable to pursue promotion goals effectively. The authors conducted a randomized trial comparing SST with cognitive therapy (CT) in a sample of 45 patients with a range of depressive symptoms to test 2 hypotheses: that SST would be more efficacious for depressed individuals characterized by inadequate socialization toward pursuing promotion goals and that SST would lead to greater reduction in dysphoric responses to priming of promotion goals. There was no overall difference in efficacy between treatments, but patients whose socialization history lacked an emphasis on promotion goals showed significantly greater improvement with SST. In addition, SST patients showed a greater reduction in dysphoric responses to promotion goal priming than did CT patients. The results illustrate the value of a theory-based translational approach to treatment design and selection.

Domestic violence against women with cancer: examples and review of the literature.

Over a recent 3-month period in our oncology practice, we became aware of multiple patients reporting domestic abuse. We present three selected cases, review the literature on domestic violence, and explore issues of diagnosis and management in a cancer population. Domestic violence against cancer patients may be more common than initially appreciated, and further awareness and research are indicated.

Self-regulatory cognition and immune reactivity: idiographic success and failure feedback effects on the natural killer cell.

Inducing depressed and anxious individuals to write about their personal goals decreases natural killer (NK) cell activity, revealing a psychobiological pathway whereby experiences of failure can influence health (Strauman et al., 1993). However, it is unclear whether similar effects also occur in non-distressed individuals. This study used the same writing task to examine the acute physiological effects of presenting idiographic success and failure feedback by priming self-congruencies or self-discrepancies on three occasions (including a control condition). Blood samples were collected after each writing session to determine NK activity, and the number and type of lymphocytes in circulation were enumerated to help explain the cytolytic changes. The two self-relevant priming conditions were associated with significant alterations in immunity, and the high self-discrepant participants were more responsive. Both self-congruent (success) and self-discrepant (failure) priming induced significant shifts in mood, which partially mediated immune alterations but did not account for them completely. If repeated and sustained over time, incidental activation of self-discrepancies and self-congruencies could account for individual variation in immune responses.

The Ironson-woods Spirituality/Religiousness Index is associated with long survival, health behaviors, less distress, and low cortisol in people with HIV/AIDS.

The purpose of this study was to determine the reliability and validity of an instrument that measures both spirituality and religiousness, to examine the relation between spirituality and religiousness and important health outcomes for people living with HIV and to examine the potential mediators of these relations. One aim was to determine whether subscales of spirituality, religiousness, or both would be independently related to long survival in people living with AIDS. The Ironson-Woods Spirituality/Religiousness (SR) Index is presented with evidence for its reliability and validity. Four factors were identified on the Ironson-Woods SR Index (Sense of Peace, Faith in God, Religious Behavior, and Compassionate View of Others). Each subscale was significantly related to long survival with AIDS. That is, the long-term survivor (LTS) group (n = 79) scored significantly higher on these factors than did the HIV-positive comparison (COMP) group (n = 200). Long survival was also significantly related to both frequency of prayer (positively) and judgmental attitude (negatively). In addition, the Ironson-Woods SR Index yielded strong and significant correlations with less distress, more hope, social support, health behaviors, helping others, and lower cortisol levels. The relation between religious behavior and health outcomes was not due to social support. Further analyses were conducted, which identified urinary cortisol concentrations and altruistic behavior as mediators of the relation between SR and long survival.

A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits.

Evidence is accumulating for physical activity as an effective, well-tolerated, highly rewarding complementary behavioral intervention for enhancing quality of life (QOL) as well as fitness among individuals with chronic and even terminal illnesses. However, relatively few studies have examined the feasibility and potential health benefits of supervised, structured exercise programs for sedentary women with primary breast cancer. Forty women over the age of 45 with primary breast cancer participated in a course of group exercise training (GET) delivered in a structured format three times per week for 16 weeks. GET emphasizes physical activities that promote aerobic fitness, strength, and flexibility. Assessments of fitness/vigor and QOL were conducted prior to, during, and upon completion of the program. Results demonstrated that GET was feasible, safe, and well-tolerated. Moreover, the participants experienced significant health benefits over the course of the intervention in multiple dimensions of fitness/vigor (aerobic capacity, strength, flexibility) as well as QOL (increased positive affect, decreased distress, enhanced well-being, and improved functioning). Discussion highlights the need for inclusion of physical activity programs in comprehensive, complementary treatment regimes for breast cancer patients.