"A sincere 'how are you?' is already a sign of acknowledgement that you're there too." - Interview study on the support needs of adolescents and young adults (AYAs) living with a parent with cancer.

PURPOSE: Parental cancer brings changes and challenges which affect the whole family. Evidence shows heightened psychosocial risk among the offspring. Research among adolescents and young adults (AYAs) facing parental cancer has mainly focused on these psychosocial problems. As a reaction, there has been an increase in research on the needs of this population, since this knowledge is crucial for developing appropriate support. Despite this increase, some AYAs are still underrepresented, namely those over eighteen years old and those who have a parent with incurable cancer. Moreover, the factors hampering or fostering access to and receipt of support addressing their needs are under-investigated. Increasing our understanding of these issues is crucial to developing more effective support interventions for these young people. Our aim was therefore to gain insight into the perceived support needs of AYAs who have a parent with cancer, including the mentioned underrepresented subgroups, and the perceived factors facilitating or hindering their use of support. METHODS: We conducted semi-structured interviews with 17 AYAs who have a parent with cancer of any type and stage, which were analyzed using conventional Qualitative Content Analysis (QCA). RESULTS: Six main categories emerged from the data, encompassing various subcategories: 1) Needs surrounding the time of disclosure, 2) Information needs, 3) Informal support needs, 4) Need for effective personal coping strategies, 5) Formal support needs, and 6) Contextual and medical factors affecting support needs. AYAs perceived family members, friends and teachers as important sources of informal support, but lacked contact with peers who also have a parent with cancer. They expressed a need for formal informational and emotional support from their parent's medical team, (onco)psychologists, and their general practitioner. AYAs faced barriers in accessing formal support. A proactive attitude from healthcare providers and information about available support would help them meet their needs. Furthermore, we shed new light on needs and issues in post-secondary education. CONCLUSIONS: AYAs who are living with their parent with cancer experience informational, emotional, and practical needs in multiple contexts, such as the home, school, leisure and hospital environment. They identify their informal and formal network as important key figures in addressing these needs.

Examining the Role of Structural and Functional Social Network Characteristics in the Context of Chronic Pain: An Ego-centered Network Design.

The well-being and functioning of individuals with chronic pain (CP) vary significantly. Social factors, such as social integration, may help explain this differential impact. Specifically, structural (network size, density) as well as functional (perceived social support, conflict) social network characteristics may play a role. However, it is not yet clear whether and how these variables are associated with each other. Objectives were to examine 1) both social network characteristics in individuals with primary and secondary CP, 2) the association between structural network characteristics and mental distress and functioning/participation in daily life, and 3) whether the network's functionality mediated the association between structural network characteristics and mental distress, respectively, functioning/participation in daily life. Using an online ego-centered social network tool, cross-sectional data were collected from 303 individuals with CP (81.85% women). No significant differences between individuals with fibromyalgia versus secondary CP were found regarding network size and density. In contrast, ANCOVA models showed lower levels of perceived social support and higher levels of conflict in primary (vs secondary) CP. Structural equation models showed that 1) larger network size indirectly predicted lower mental distress via lower levels of conflict; 2) higher network density increased mental distress via the increase of conflict levels. Network size or density did not (in)directly predict functioning/participation in daily life. The findings highlight that the role of conflict, in addition to support, should not be underestimated as a mediator for mental well-being. Research on explanatory mechanisms for associations between the network's structure, functionality, and well-being is warranted. PERSPECTIVE: This paper presents results on associations between structural (network size, density) and functional (social support, conflict) social network characteristics and well-being in the context of CP by making use of an ego-centered network design. Results suggest an indirect association between structural network characteristics and individuals with CP their mental well-being.

The psychological impact of genetic testing in childhood cancer: A systematic review.

OBJECTIVE: Cancer predisposition syndromes are being more frequently recognized in the etiology of pediatric oncology and genetic-related technologies are evolving rapidly, leading to an increasing availability of genetic testing for families. This systematic review assessed the psychological impact of genetic testing on children and parents in the context of childhood cancer. METHODS: Searches were performed using three databases (Web of Science, Pubmed and Embase) to identify relevant empirical studies. Following Cochrane guidelines, we screened 3838 articles and identified 18 eligible studies, representing the perspectives of children and/or parents. RESULTS: The included studies described the impact of genetic testing in different contexts (e.g. predictive testing and diagnostic testing) and in different subgroups, (e.g. carriers and non-carriers). Overall, the studies did not identify clinically-relevant long-term increases in negative emotions (depression, anxiety, distress, uncertainty, guilt) as a result of genetic testing. Negative emotions were typically time-limited and generally occurred in families with particular characteristics (e.g. those with a history of multiple cancer diagnoses, families receiving an unfavorable result for one child and a favorable result in siblings, and those with pre-existing mental health difficulties). Positive emotions (hopefulness, relief and peace of mind) were also reported. Knowing their genetic risk status appeared to help to foster empowerment among families, regardless of the result and any associated emotions. CONCLUSIONS: Genetic testing in pediatric oncology does not appear to cause significant additional harm and can lead to positive outcomes. Clinicians need to be especially attentive when counseling families at increased risk of distress.

Relational needs frustration: an observational study on the role of negative (dis)engaging emotions.

The present study aimed to explore the role of partners' negative engaging and disengaging emotions in dealing with the frustration of autonomy and relatedness needs during conflict. In an observational study, partners from 141 heterosexual couples participated in a conflict interaction task followed by a video-mediated recall procedure during which they reported their level of relational need frustration and their emotions experienced at different moments during the interaction. Results showed that in partners, more autonomy frustration, experienced at the beginning of the conflict, was accompanied by more concurrent negative disengaging emotions (anger, irritation), whereas more relatedness frustration was accompanied by more negative engaging emotions (hurt, sadness, disappointment). Additionally, the concurrent association between partners' relatedness frustration and their experience of negative engaging emotions was negatively moderated by their own relatedness relationship beliefs (as assessed by background questionnaires), indicating that for individuals who considered relatedness to be less important, relatedness frustration and negative engaging emotions were more strongly linked than for people with high relatedness beliefs. Finally, negative engaging emotions - assessed at the beginning of the conflict - were associated with more relatedness frustration at a subsequent time point in the interaction in men, but not in women. This study contributes to our understanding of how partners' negative emotions and the frustration of important relational needs are intertwined.

An ecological approach to understanding the impact of sexual violence: a systematic meta-review.

Aim: A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence. Methods: Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted. Results: Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however. Conclusion: Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.

Motivation and empathic accuracy during conflict interactions in couples: it's complicated!

The aim of this study was to broadly investigate the role of relationship-, self-, and partner-serving motivation in empathic accuracy in couples' conflict interactions. To this end, a laboratory study was set up in which couples (n = 172) participated in a conflict interaction task, followed immediately by a video-review task during which they reported their own feelings and thoughts and inferred those of their partner to assess empathic accuracy. We used both trait and state measures of relationship-, self-, and partner-serving motivation, and we experimentally induced these three categories of motivation. Relationship-serving state motivation predicted greater empathic accuracy. In contrast, experimentally induced partner-serving motivation resulted in less empathic accuracy for men. Self-serving motivation was not found to be associated with empathic accuracy, nor were any of the trait measures. These findings underscore the complexity of the association between motivation and empathic accuracy in partners' conflict interactions. Supplementary Information: The online version contains supplementary material available at 10.1007/s11031-022-09982-x.

Couples' We-Ness and Separateness During the COVID-19 Pandemic and Lockdown: A Longitudinal Perspective.

This 5-wave longitudinal study aimed to monitor the feeling of we-ness and separateness over one year of the COVID-19 pandemic by examining partners' natural pronoun usage when reporting couple interactions. Compared to the start of the pandemic, a general decline of we-ness was found after one year. Moreover, the changes in couple we-ness were non-linear, resulting in an increase at the end of the strict lockdown, followed by a decrease. No change in couple separateness was found.

Protective factors enhancing resilience in children of parents with a mental illness: a systematic review.

Objectives: A systematic review was conducted to (1) investigate protective factors enhancing resilience in children of parents with a mental illness (COPMI), and (2) examine theoretical and methodological issues in the existing literature. Method: Following guidelines for systematic reviews, searches were performed using Web of Science, Pubmed and Embase. After screening 5,073 articles 37 fulfilled inclusion criteria and were extracted for review. Results of the present review indicate that there are several ways to help build resilience in COPMI. More specifically, five protective factors emerged from the reviewed literature: Information, Support, Family functioning and Connectedness, Child coping, and Parenting. Discussion: Research on protective factors in children confronted with parental mental illness is still scarce and for some factors no clear conclusions can be drawn based on the available evidence. To further our understanding of the building blocks and underlying mechanisms of resilience in COPMI, additional rigorously designed studies are needed.

When the Partner's Reality Bites: Associations Between Self- and Partner Ratings of Psychopathic Traits, Relationship Quality and Conflict Tactics.

The present study examined associations of self- and partner-reported psychopathic traits, as well as the level of agreement between these reports (perceptual accuracy), with relationship quality, and the moderating role of violent and non-violent conflict tactics. Participants were 259 heterosexual couples from the community. Results indicated that, despite moderate convergence between self- and partner-reports, the female partners tended to underreport the levels of psychopathic traits in their male partner. Relationship quality was negatively associated with partner-reported and, albeit to a lesser extent, self-reported psychopathic traits. Contrary to expectations, perceptual accuracy was barely associated with relationship quality. Whereas no evidence was found for the moderating role of aggressive conflict tactics, non-violent negotiation seemed to buffer the effect of psychopathic traits on relationship quality. The study highlights the importance of considering the partner's perceptions as well as constructive conflict tactics when examining psychopathic traits in intimate relationships.

Intimate Relationships in Times of COVID-19: A Descriptive Study of Belgian Partners and their Perceived Well-Being.

How did couples in Belgium cope during the early phases of the COVID-19 pandemic? In this study, grounded in relationship science, we investigated in a descriptive manner several factors that could affect how couples perceived individual and relational wellbeing during this time. Specifically, we examined the associations between gender, sexual orientation, parental status, and relationship duration on participants' self-reported individual and relational well-being after the first lockdown (more generally and more specific in response to COVID-19). Additionally, we investigated if relational well-being predicted perceived change in individual well-being from pre- to post-COVID-19 regulations. To test these hypotheses, self-report data was collected during the Summer of 2020 in both the Dutch and French speaking part of Belgium. Data from 679 participants suggested that individual and relational well-being only differed based on parental status (and not by gender nor sexual orientation). Importantly, parents reported lower relational well-being than participants without children, while participants without children reported higher perceived increases in depression. People that had been in a relationship for longer also reported lower relational well-being, but this relationship was explained by other confounding factors. Relational well-being buffered increases in individual distress that people perceived to have occurred pre-COVID-19 regulations to after COVID-19 regulations went into effect. These findings might inform practice and policy for individuals in a romantic relationship during the COVID-19 pandemic.

Expressing thoughts and feelings leads to greater empathic accuracy during relationship conflict.

Many couple therapies focus on enhancing the disclosure of thoughts and feelings, and on an accurate understanding of these. But does the expression of thoughts and feelings lead to better empathic accuracy, as is generally assumed? In this study, we explicitly tested a dynamic expression-leading-to-accuracy account of empathic accuracy in intimate relationships. Specifically, in the conflict interactions of 155 mixed-sex couples, we investigated (a) whether greater momentary expressions of the target (self-reported vs. observed) were associated with more empathic accuracy in the perceiver; (b) whether this outcome was similar for the expression of thoughts versus feelings; and (c) whether the expression-leading-to-accuracy link was moderated by the perceived threat level of these thoughts and feelings. The data revealed that greater (self-reported and observed) expression of the target's thoughts and feelings was associated with better empathic accuracy by the partner; that this association was similar for thoughts and feelings; and that this link was not moderated by the perceived threat level of these thoughts and feelings. These findings confirm a fundamental assumption of couples therapy and have important implications for therapeutic interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Siblings Dealing with Pediatric Cancer: A Family- and Context-oriented Approach.

Background: Pediatric cancer is a severe life-threatening disease that poses significant challenges to the life of the siblings. Based on the social ecology model, the current study is aimed at exploring the association between intrafamilial (family functioning, family support) and contextual (network support) resources, and the individual adjustment of siblings facing cancer in their brother/sister. Methods: Participants were 81 siblings of children with leukemia or non-Hodgkin lymphoma. The mean siblings' age was 10.32 years. Siblings completed the Family Environment Scale, the Social Support Questionnaire for Children, the Situation-Specific Emotional Reactions Questionnaire, and the Pediatric Quality of Life Inventory. Data were analyzed using a multi-level approach. Results: Family functioning, family support, and network support proved to be related to siblings' cancer-related emotional reactions post-diagnosis. In addition, the present study suggests taking into account the gender of the ill child and the age of the siblings. Discussion: Our findings led to the conclusion that resources at both the intrafamilial level and the contextual level are important for explaining sibling adjustment post-diagnosis. Interventions targeting the sibling, the family, and the external network are warranted to enhance sibling adjustment.

A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study.

OBJECTIVE: Dyadic coping is a process of coping within couples that is intended not only to support the patient with chronic pain but also to maintain equilibrium in the relationship. This study aims to investigate the effect of patient-perceived and spouse-reported dyadic coping on both the patient and their partner's relationship quality and anxiety, stress, and depression over time. METHODS: One hundred thirty-nine couples, with one partner experiencing chronic pain, participated in this study. Spanning three measurements over six months, couples reported on their anxiety, stress, depression, relationship quality, and dyadic coping. RESULTS: Patient-perceived supportive dyadic coping was positively associated with both partners' relationship quality but was negatively associated with spouses' stress over time. Patient-perceived negative dyadic coping was negatively associated with both partners' relationship quality and positively associated with patients' depression and spouses' depression and stress over time. Spouse-reported supportive dyadic coping showed a positive association with their own relationship quality and a negative association with spouses' depression at baseline and patients' depression at three-month follow-up. Spouse-reported negative dyadic coping was negatively associated with their relationship quality at baseline and positively associated with their partner's anxiety and stress at six-month and three-month follow-up, respectively. Similar inference was observed from the findings of growth curve model. CONCLUSIONS: As compared with spouse report, patient perception of dyadic coping is a better predictor of both partners' relationship quality and psychological outcomes over time. Both partners may benefit from early psychosocial intervention to improve their dyadic coping, relationship quality, and psychological outcomes.

The family practice of support-giving after a pediatric cancer diagnosis: A multi-family member interview analysis.

PURPOSE: Pediatric cancer presents many challenges to the life of the child diagnosed with cancer and his/her family. Among the studies investigating risk and protective factors, social support has emerged as an important construct. However, little is known on how family members support each other in this particular context. METHOD: In order to further explore this process, interviews were performed separately with mothers, fathers and siblings. For the purpose of this study (as this is part of a larger project), data from four families in which both parents and at least one sibling participated, were used. Multi Family Member Interview Analysis was used as the methodological framework to analyze the individual interviews, allowing a detailed and systematic analysis of shared family experiences. RESULTS: The analysis of the data revealed three themes: Being together matters: the families identified the need of being physically together; Finding support in (not) talking: the complexity of sharing emotions was explained and Working together as a team: the families described working together as a team in order to get everything organized. CONCLUSIONS: This study broadens our understanding of the interpersonal process of family support-giving when facing pediatric cancer. When meeting with families, families should be invited as a unit in order to best capture family level experiences. Also, clinicians should be sensitive to the different cancer-related communication needs within the family (i.e., the need to talk or not to talk) and incorporate this knowledge into their care.

Family Members Dealing With Childhood Cancer: A Study on the Role of Family Functioning and Cancer Appraisal.

OBJECTIVES: Childhood cancer is a life-threatening disease that poses significant challenges to the life of the diagnosed child and his/her family members. Based on the ABCX-model, the aim of the current study was to explore the association between family functioning, cancer appraisal and the individual adjustment of patients, parents and siblings. METHODS: Participants were 60 children with leukemia or non-Hodgkin lymphoma, 172 parents and 78 siblings (115 families). Time since diagnosis varied from zero to 33 months. Patients, parents and siblings completed the Family Environment Scale (FES), Perceived Stress Scale, Situation-Specific Emotional Reactions Questionnaire and Pediatric Quality of Life Inventory/Maudsley Marital Questionnaire. RESULTS: Family functioning and the appraisal of the cancer diagnosis proved to be related to patients', parents' and siblings' cancer-related emotions and quality of life post-diagnosis. In addition, family members differed in their perception of some family functioning domains, the appraisal of the cancer diagnosis, positive feelings and quality of life. DISCUSSION: Our findings led to the conclusion that family functioning and the appraisal of the cancer diagnosis are important for the individual adjustment of patients, parents and siblings when facing a diagnosis of cancer in the child. Differences across members within one family and differences between families speak to the need of screening all family members and intervening at the level of individual as well as the family unit.

Couples Dealing With Pediatric Blood Cancer: A Study on the Role of Dyadic Coping.

Objective: Pediatric cancer is a life-threatening disease that poses significant challenges to the ill child and his/her parents. Among the studies investigating risk and protective factors for the individual and relationship adjustment of parents being confronted with pediatric cancer, couple factors - such as dyadic coping - gained little research attention. Therefore, the aim of the current study was to explore the association between dyadic coping and individual/relationship outcomes of parents in the context of pediatric cancer. Methods: Participants were 59 couples of children diagnosed with leukemia or Non-Hodgkin lymphoma. Time since diagnosis varied from diagnosis to 20 months. Both parents completed the DCI-short, DASS21, PIP, and MMQ. Results: Positive dyadic coping (i.e., supportive and common dyadic coping) and negative dyadic coping proved to be related to individual and relational outcomes of parents facing cancer in their child. In addition, while men and women reported to be equally satisfied with their partner and their sexual relationship, women reported higher levels of individual maladjustment. Conclusion: Our findings led to the conclusion that dyadic coping is important for both individual as well as relationship outcomes of parents when facing a diagnosis of cancer in their child. When meeting with families, both partners should be invited as a unit in order to best capture couple level experiences. Also, clinicians should be sensitive to relational and sexual issues besides individual issues, taking into account evidence-based standards for psychosocial care in pediatric oncology.

Family Adjustment When Facing Pediatric Cancer: The Role of Parental Psychological Flexibility, Dyadic Coping, and Network Support.

OBJECTIVES: Pediatric cancer is a life-threatening disease that poses significant challenges to the life of all family members (diagnosed child, parents, and siblings) and the family as a whole. To date, limited research has investigated family adjustment when facing pediatric cancer. The aim of the current study was to explore the role of protective factors at the individual (parental psychological flexibility), intrafamilial (dyadic coping) and contextual level (network support) in explaining family adjustment as perceived by parents of children with leukemia or non-Hodgkin lymphoma. In addition, we were interested to see whether these protective factors could be predictive for family adjustment at a later time point. METHOD: Participants were 70 mothers and 53 fathers (80 families) of children with leukemia or non-Hodgkin lymphoma. Mean time since diagnosis was 5.26 (T1) and 18.86 (T2) months post-diagnosis. Parents completed the Acceptance and Action Questionnaire II (to assess psychological flexibility), Dyadic Coping Inventory, a network support questionnaire, Impact on Family Scale and the Family Adjustment Scale. Both concurrent and prospective association models were tested. RESULTS: Psychological flexibility, dyadic coping and network support proved to be cross-sectionally and positively related to parents' perception of family adjustment post-diagnosis; psychological flexibility and dyadic coping proved to predict better family adjustment over time. CONCLUSION: Our findings led to the conclusion that protective factors at all three levels (individual, intrafamilial and contextual) are important for explaining family adjustment as perceived by parents facing a diagnosis of cancer in their child. Interventions targeting the individual, couple, as well as family level are warranted to enhance family adjustment.

Siblings' Experiences of Everyday Life in a Family Where One Child Is Diagnosed With Blood Cancer: A Qualitative Study.

BACKGROUND: Childhood cancer not only presents challenges to the life of the child with cancer but also to the siblings' daily family life. The aim of the current study was to gain a better understanding of siblings' experiences of living in a family where one child has been diagnosed with blood cancer. METHOD: Ten siblings of children with leukemia or non-Hodgkin lymphoma completed a semistructured interview about their everyday family life experiences postdiagnosis. The verbatim transcripts of the interviews served as the data for an interpretative phenomenological analysis. RESULTS: The results showed that overall the siblings experienced a continuity in many aspects of their family life: they still experienced their family as an important source of support and information/communication, as warm and loving and as a safe harbor where family members aim to protect each other. However, at the same time, the participating siblings also expressed that some things felt unmistakably different postdiagnosis: They felt that their family as a whole had been ripped apart, with a greater focus on the diagnosed child and changing responsibilities for each family member. CONCLUSION: This study informs parents and clinicians about the daily family life experiences from the siblings' perspective, a perspective that is often overlooked. A focus on challenges as well as continuities within family life, the wish for connection expressed by the siblings, and the uniqueness of every sibling's experiences is what can be taken away from this study by psychosocial workers in the field.

Social Support, Adjustment, and Psychological Distress of Help-Seeking Expatriates.

The present study aimed to explore the interrelations between support processes, adjustment, and psychological distress within a sample of help-seeking expatriates. Specifically, we examined (1) the association between expatriates' cross-cultural adjustment (i.e., work, interaction and general adjustment) and levels of psychological distress (i.e., depression, anxiety and stress), (2) the association between expatriates' perceptions of socioemotional and instrumental support availability and their level of cross-cultural adjustment, and (3) the moderating role of expatriates' socioemotional and instrumental support needs in the latter association. Findings showed that lower levels of expatriates' work adjustment were associated with higher levels of psychological distress. Further, perceived availability of socioemotional support was positively linked to expatriates' interaction and work adjustment. Finally, instrumental support needs moderated the relationship between instrumental support availability and general adjustment such that higher levels of instrumental support availability were associated with better general adjustment, but only for expatriates reporting high needs for instrumental support. Our study represents a novel contribution to the expatriate literature by shedding light on expatriates' vulnerability for psychological distress and understanding the type of social support that is considered most beneficial for help-seeking expatriates. Suggestions are made for clinical interventions for expatriates in need of support.