Hypnosis and cognitive behavioral therapy with online sessions to reduce fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: Rational and study protocol for a feasibility study.

Background: In metastatic colorectal cancer (CRCm), fatigue is pervasive, reduces quality of life, and is negatively associated with survival. Its course is explained in part by psychosocial variables such as emotional distress, coping strategies, or perceived control. Thus, to reduce fatigue, psychosocial interventions appear to be relevant. In some cancers, Cognitive Behavioral Therapies (CBT) reduce fatigue. Hypnosis is also used as a complementary therapy to reduce the side effects of cancer. While CBT requires specific training often reserved for psychologists, hypnosis has the advantage of being increasingly practiced by caregivers and is therefore less expensive (Montgomery et al., 2007). On the other hand, CBT and hypnosis remain understudied in the CRC, do not focus on the symptom of fatigue and in Europe such programs have never been evaluated. Objectives: Implementing an intervention in a healthcare setting is complex (e.g., economic and practical aspects) and recruiting participants can be challenging. The primary objective will therefore be to study the feasibility of two standardized interventions (hypnosis and CBT) that aim to reduce fatigue in patients with CRCm treated in a French cancer center. Methods and design: A prospective, single-center, randomized interventional feasibility study, using mixed methods (both quantitative and qualitative). A total of 60 patients will be allocated to each intervention group [Hypnosis (n = 30) and CBT (n = 30)]. Participants will be randomized into two parallel groups (ratio 1:1). Both programs will consist of 6 weekly sessions focusing on the CRF management over a period of 6 weeks. Trained therapists will conduct the program combining 3 face-to-face sessions and 3 online sessions. The feasibility and experience of interventions will be evaluated by the outcome variables, including the adhesion rate, the reasons for acceptability, relevance or non-adherence, the satisfaction, the fatigue evolution (with ecological momentary assessments), and the quality of life. All questionnaires will be self-assessment using an online application from the cancer center. Discussion: Results will highlight the barriers/facilitators to the implementation of the program and the relevance of the program to the patients, and will be used to generate hypotheses for a randomized control trial. Clinical trial registration: ClinicalTrials.gov Identifier: NCT04999306; https://clinicaltrials.gov/ct2/show/NCT04999306.

'Bad news consultations' with oncology nurses: Impact on perceived stress and patient experience.

PURPOSE: 'Bad News Consultations' (BNC), conducted by nurses who are specialists in cancer, have been institutionally implemented in all French anti-cancer centres, to support the patient facing announcement-related stress. This study aimed to 1/describe the impact of the BNC on the patient's perceived stress and 2/determine the patient's benefits from the BNC. METHOD: This monocentric study, cross-sectional evaluation, used a mixed method, both quantitative and qualitative. During 8 months, 336 eligible participants who underwent a BNC were recruited by nurses. Perceived stress was self-assessed with a validated Visual Analogic Scale (VAS), at the beginning and at the end of the BNC. Stress resilience was self-assessed once using the CD-RISC2. Qualitative experiences were explored after the BNC, using a 25-item questionnaire. Multivariate analyses were conducted on perceived stress measures (on the VAS) to test mixed-effects models, including initial predispositions (e.g., stress resilience) and organisational constraints (e.g, interval between the medical consultation and the BNC). RESULTS: Analyses on the perceived stress measures revealed a significant and negative effect of Time (B = -1.91; p < .001), Gender (B = 0.72; p = .03), and Resilience score (B = -0.43; p < .001), without any significant effect of the other incorporated random effects (i.e., Type of cancer/treatment) nor fixed effects (i.e., Age, Organisational constraints). Patients mostly reported having received necessary information, having their addressed emotions with empathetic responses and respect, perceived benefits in the healthcare pathway, and heard of some supportive cares. CONCLUSION: Perceived stress was reduced after BNCs. According to the patients, the BNCs allowed a better patient-centered communication and a better care pathway.

[Non-pharmalogical interventions and breast cancer: What benefit in addition to radiotherapy?] / Interventions non médicamenteuses et cancer du sein : quel bénéfice en complément d'une radiothérapie ?

Adjuvant radiotherapy is one of the major anticancer treatments in early breast cancer patients. Acute and late radio-induced effects may occur during or after breast cancer radiotherapy, and their medical management is a major issue for radiation oncologists. Here, the present review of literature embraces complementary non-pharmacological interventions, which could be combined to adjuvant radiotherapy in order to improve patients care.

Alexithymia impairs the cognitive control of negative material while facilitating the recall of neutral material in both younger and older adults.

We investigated the moderating impact of the personality construct alexithymia on the ability of younger and older adults to control the recall of negative and neutral material. We conducted two experiments using the directed forgetting paradigm with younger and older adults. Participants studied negative (Experiment 1) or neutral (Experiment 2) words. Participants were instructed to forget the first half and remember the second half of an entire list of words. Overall, we found that alexithymia impairs the ability of both younger and older adults to cognitively control negative material (through both recall and inhibition). The "externally oriented thinking" factor of alexithymia appears to play a particularly pertinent role in terms of inhibiting negative material. Furthermore, older adults recalled fewer sought after negative items, but this was not evident in terms of inhibition. In contrast, only age (older adults) negatively impacted the recall of sought after neutral items. Interestingly, alexithymia had the opposite effect: the "difficulty in identifying emotions" factor of alexithymia was associated with an increased recall of neutral items. We discuss these results in terms of alexithymia and its impact on cognitive control.

Olfactory-visual congruence effects stable across ages: yellow is warmer when it is pleasantly lemony.

This study aimed to examine the age-related differences in the olfactory-visual cross-correspondences and the extent to which they are moderated by the odors pleasantness. Sixty participants aged from 20- to 75- years (young, middle-aged and older adults) performed a priming task to explore the influence of six olfactory primes (lemon, orange, rose, thyme, mint and fish) on the categorization (cool vs. warm) of six subsequent color targets (yellow, orange, pink, malachite green, grass-green, and blue-gray). We tested mixed effects models. Response times were regressed on covariates models using both fixed effects (Groups of age, olfactory Pleasantness and multimodal Condition) and cross-random effects (Subject, Color and Odor). The random effects coding for Odor (p < .001) and Color (p = .001) were significant. There was a significant interaction effect ( p= .004) between Condition × Pleasantness, but not with Groups of age. The compatibility effect (i.e., when odors and colors were congruent, the targets processing were facilitated) was as much enhanced as the olfactory primes were pleasant. Cross-correspondences between olfaction and vision may be robust in aging. They should be considered alongside spatiotemporal but also emotional congruency.

Habit and recollection in healthy aging, mild cognitive impairment, and Alzheimer's disease.

OBJECTIVES: This study aimed to create a new French version of the Hay and Jacoby habit-training procedure (1996; 1999) and apply it to novel populations to determine the degree to which habit and recollection were affected. METHOD: 36 young, 32 middle-aged, and 37 older adults participated in Experiment 1. 17 controls, 17 patients with amnestic Mild Cognitive Impairment (a-MCI), and 17 patients with Alzheimer's disease (AD) were involved in Experiment 2. Participants were assessed across a variety of demographic, neuropsychological and psychopathological variables (e.g., depressive affects, subjective experience of cognitive failures, interference sensitivity). The habit-training process-dissociation was used to explore the cognitive mechanisms underlying memory slips to separate the contribution of habit and recollection to memory performance. RESULTS: The data show a very clear pattern of decreased recollection with age, F(2, 102) = 25.12, p < .001, η²(p) = .197, and age-related neurological impairment, F(2, 48) = 39.22, p < .001, η²(p) = .62, with intact use of habit-based memory. Additional evidence for the validity of the process estimates is provided by theoretically meaningful correlations between the process estimates and measures of attentional control (Stroop test: r = -0.40) and subjective memory complaint (r = -0.45). CONCLUSIONS: Although likely not the same as familiarity, the data add to a growing literature suggesting that controlled forms of memory decline with age and in age-related neurological conditions (MCI and AD) whereas more automatic forms of memory (habit) remain intact. This research should improve understanding of memory complaints, preclinical and clinical dementia, and help target processes for rehabilitation.

[Memory controlled processes between the young and old: the birth of cognitive complaint?]. / Rencontre entre mémoire et contrôle chez des jeunes et des aînés : la naissance d'une plainte ?

The aim of this study is to explore cognitive complaint by investigating the influence of memory controlled processes (recollection) and metacognitive beliefs. Several methodological precautions were taken in order to control neuropsychological and psychopathological criteria, like anxiety, depression or objective memory trouble. The "habit paradigm" (Hay & Jacoby, 1999) was used to create a "memory slips" task, and to estimate the contributions of recollection and habit to performance. Besides, participants were asked to complete questionnaires in order to assess cognitive complaint (CDS) and metacognitive beliefs (MCQ). Results showed that neither cognitive complaint nor metacognitive beliefs differed significantly between young and older persons. However, statistical analysis did show cognitive dissociations in function of cognitive complaint. Finally, depressive affects, memory controlled processes and metacognitive beliefs about the controllability of thoughts appeared as good predictors of memory complaint. In spite of our study limitations, we discuss our results in terms of clinical implications.