To evaluate the relationship between personality and emotional distress in prostate cancer. Neuroticism and introversion were hypothesized to be associated with clinically significant symptoms of emotional distress, including depression, anxiety, and suicidal ideation.
Self-complexity, the extent that people experience themselves as having a number of distinct and meaningful social roles, may have implications for young adults’ socio-emotional adjustment to romantic life events. Based on prior research, we hypothesized that participants who reported lower self-complexity would have worse adjustment to a negative event (not having a date on Valentine’s Day) but better adjustment to a positive event (having a date). Participants ( N = 325) completed measures of self-complexity and depression symptom severity at study entry. Approximately a month later, at the end of the day on Valentine’s Day, they completed a measure of emotion-regulation strategies and a reassessment of depression symptom severity. The hypothesized interaction was statistically significant; self-complexity was associated with better emotion-regulation ( R 2 = .15, p < .001) and depression outcomes ( R 2 = .05, p = .001) for non-daters, but worse outcomes for daters. Our findings suggest that self-complexity is related to self-regulation and has implications for adjustment to a range of life events.
In the wake of COVID-19, the capacity to track emerging trends in mental health symptoms and needs will guide public health responses at multiple ecological levels. Using Google Trends to track population-level mental health-related Google searches in the United States, this investigation identified pandemic-associated spikes in searches related to anxiety symptoms and remote treatments for anxiety, such as deep breathing and body scan meditation. As other discernable population-level changes in mental health have yet to emerge, continued surveillance is warranted. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
ContextThere has been surprisingly little attention to conceptual and methodological issues that influence the measurement of discretionary utilization at the end of life (DIAL), an indicator of quality care.ObjectiveThe objectives of this study were to examine how DIALs have been operationally defined and identify areas where evidence is biased or inadequate to inform practice.MethodsWe conducted a scoping review of the English language literature published from 1/1/04 to 6/30/17. Articles were eligible if they reported data on ≥2 DIALs within 100 days of the deaths of adults aged ≥18 years. We explored the influence of research design on how researchers measure DIALs and whether they examine demographic correlates of DIALs. Other potential biases and influences were explored.ResultsWe extracted data from 254 articles published in 79 journals covering research conducted in 29 countries, mostly focused on cancer care (69.1%). More than 100 DIALs have been examined. Relatively crude, simple variables (e.g., intensive care unit admissions [56.9% of studies], chemotherapy [50.8%], palliative care [40.0%]) have been studied more frequently than complex variables (e.g., burdensome transitions; 7.3%). We found considerable variation in the assessment of DIALs, illustrating the role of research design, professional norms and disciplinary habit. Variables are typically chosen with little input from the public (including patients or caregivers) and clinicians. Fewer than half of the studies examined age (44.6%), gender (37.3%), race (26.5%), or socioeconomic (18.5%) correlates of DIALs.ConclusionUnwarranted variation in DIAL assessments raises difficult questions concerning how DIALs are defined, by whom, and why. We recommend several strategies for improving DIAL assessments. Improved metrics could be used by the public, patients, caregivers, clinicians, researchers, hospitals, health systems, payers, governments, and others to evaluate and improve end-of-life care.
In advanced cancer, patients want to know how their care options may affect survival and quality of life, but the impact of outpatient specialty palliative care on these outcomes in cancer is uncertain. To estimate the impact of outpatient specialty palliative care programs on survival and quality of life in adults with advanced cancer. Following PRISMA guidelines, we conducted a systematic review and meta-analysis of randomized controlled trials comparing outpatient specialty palliative care with usual care in adults with advanced cancer. Primary outcomes were 1 year survival and quality of life. Analyses were stratified to compare preliminary studies against higher-quality studies. Secondary outcomes were survival at other endpoints and physical and psychological quality-of-life measures. From 2,307 records, we identified nine studies for review, including five high-quality studies. In the three high-quality studies with long-term survival data (n = 646), patients randomized to outpatient specialty palliative care had a 14% absolute increase in 1 year survival relative to controls (56% vs. 42%, p < .001). The survival advantage was also observed at 6, 9, 15, and 18 months, and median survival was 4.56 months longer (14.55 vs. 9.99 months). In the five high-quality studies with quality-of-life data (n = 1,398), outpatient specialty palliative care improved quality-of-life relative to controls (g = .18, p < .001), including for physical and psychological measures. Patients with advanced cancer randomized to receive outpatient specialty palliative care lived longer and had better quality of life. Findings have implications for improving care in advanced cancer.
Self-compassion is a positive way of relating to oneself. Self-compassion involves self-kindness, recognising that difficulties are part of being human, and being present and non-judgemental regarding one’s thoughts and feelings. Self-compassion is associated with reduced stress, yet there has been no study which assesses the magnitude of this relationship. In the first part of the thesis, a meta-analysis was conducted to achieve this.
The meta-analysis combined the results of 26 studies with 37 effect sizes, finding that self-compassion has a medium inverse relationship with objective stress, measured through bodily responses, and a large inverse relationship with subjective perceived stress, measured through self-report questionnaires. The meta-analysis also found that self-compassion relates to reduced stress equally in clinical and non-clinical populations, and that gender and age do not influence the magnitude of this relationship.
Whilst self-compassion is a trait that is in part developed in childhood, it can be cultivated through psychological interventions. Psychological interventions aimed at cultivating self-compassion, if successful in this, could be beneficial in reducing stress, particularly self-reported perceived stress.
Psoriasis is a skin condition that can be influenced by stress. Stress is of particular relevance in psoriasis as it is associated with inflammation and maladaptive health behaviours, including poor treatment adherence, which increase the severity of psoriasis and associated itchiness. In the second part of the thesis, a research study was conducted to investigate the relationships between self-compassion, perceived stress, treatment adherence, and psoriasis severity and itch severity in participants with psoriasis. Participants were then randomly allocated to complete either a brief online self-compassionate writing intervention, or an active control condition.
There was a large inverse relationship between self-compassion and perceived stress. There was a small relationship between self-compassion and treatment adherence. There were small inverse relationships between self-compassion and psoriasis severity, and itch severity. The relationship between self-compassion and itch severity was found to be in part explained by perceived stress. The brief online self-compassionate writing intervention had a small effect in cultivating state self-compassion, but there were no changes in self-compassion, perceived stress, treatment adherence, psoriasis severity, or itch severity at a four-week follow-up that could be attributed to the effects of the brief online self-compassionate writing intervention. The results of the research study add to the evidence that self-compassion is associated with reduced stress and increased treatment adherence in the context of physical health. Further research is needed to investigate the potential benefits of psychological interventions aimed at cultivating self-compassion in this area.
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