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This study investigated: (a) the effect of emotion regulation (cognitive reappraisal and expressive suppression) on psychological distress and well‐being of couples in long‐term marriages, using longitudinal data; and (b) the influence of spouses' emotion regulation on psychological outcomes in the actor–partner interdependence model. In this longitudinal study, we conducted a baseline survey and a 1‐year follow‐up to analyze data of 66 couples (N = 132; duration of marriage, M = 36.82 years, SD = 6.83 years; husband's age, M = 64.50 years, SD = 4.05 years; and wife's age, M = 61.39 years, SD = 4.82 years) living in Japan. Emotion regulation, psychological well‐being, psychological distress, and various control variables (age, education level, duration of the marriage, and household income) were assessed. Hierarchical linear modeling with distinguishable dyads was used to determine actor–partner interdependence in the effect of emotion regulation on mental health. The actor effect was observed in both husbands and wives when baseline cognitive reappraisal was predicted to positively influence psychological well‐being in the follow‐up. However, this effect was not observed for expression suppression. Additionally, regarding psychological distress, there were no actor or partner effects in either reappraisal or suppression. Possible reasons for these findings, including cultural differences, are discussed in this study. [ABSTRACT FROM AUTHOR]

Messages to promote health behavior are essential when considering health promotion, disease prevention, and healthy life expectancy. The present study aimed to examine whether (1) positive and negative goal-framing messages affect message memory and behavioral intention differently in younger, middle-aged, and older adults, (2) framing effects are mediated by interest in health (health promotion and disease prevention) and emotion regulation (cognitive reappraisal and expressive suppression), and (3) mediation effects differ between positive and negative frames. Participants (N = 1248) aged 20 to 70 years were divided into positive and negative frame conditions. Framing demonstrated interactive effects on message memory; all age groups showed higher recognition accuracy in the positive than the negative frame. The accuracy of younger adults was higher than that of older adults in the negative frame, while older adults showed higher accuracy than younger adults in the positive frame. Additionally, recognition accuracy was higher in the positive frame, as participants had higher interest in health promotion and used cognitive reappraisal more frequently. Contrariwise, emotion regulation and interest in health promotion did not have significant effects on memory in negative frames. Moreover, regardless of the message valence, age did not influence behavioral intention directly but was mediated by interest in health and emotion regulation, while the older the participants were, the higher their interest in health, resulting in higher intention. For emotion regulation, intention increased with higher reappraisal scores and decreased with increasing suppression. Our results suggest that interest in health and emotion regulation should be considered when examining the relationship between age and goal-framing for health messages. [ABSTRACT FROM AUTHOR]

Background: Actions in preparation for death and talks about death between advanced cancer patients and their families are considered essential to achieve a good death. However, little is known about the prevalence of such actions compared with talks and their association with bereaved familie's psychological morbidity. Objective: To clarify the prevalence of bereaved families having acted in preparation for death and talked about death with their loved one and to explore their associations with bereaved familie's depression and complicated grief (CG). Design: A nationwide survey. Setting/Subject: A total of 999 bereaved families of cancer patients admitted to 133 inpatient hospices in Japan. Measurements: The prevalence of familie's actions in preparation for and talks about death, Patient Health Questionnaire (PHQ)-9 and Brief Grief Questionnaire (BGQ). Results: Among 678 bereaved families (response rate = 68%), 513 (76%) acted in preparation for death and 315 (46%) talked about death with their loved one. Those who acted and talked were significantly less likely to suffer depression (PHQ-9 ⩾ 10) than those who neither acted nor talked (odds ratio [OR], 0.405; 95% confidence interval [CI], 0.195-0.845; adjusted p = 0.016). Families who acted were significantly less likely to suffer complicated grief (CG; BGQ ⩾8), whether they talked (OR, 0.394; 95% CI, 0.185-0.84; adjusted p = 0.016) or not (OR, 0.421; 95% CI, 0.191-0.925; adjusted p = 0.031). Conclusions: Most families acted in preparation for death and those who acted were less likely to suffer depression and CG. Clinicians may minimize familie's later psychological morbidity by helping patients and families act in preparation for death. [ABSTRACT FROM AUTHOR]

Objective: We evaluated avoidance behaviors of healthy partners of breast cancer patients and sought to (1) describe men's perception of their own avoidance behavior and (2) identify the background factors associated with such behavior.Methods: An Internet-based survey was conducted, and analysis was performed on the responses of 368 male spouses of female breast cancer patients.Results: Thirty to forty percent of spouses had some type of problem avoidance behavior toward their wives. There was a high correlation (r = 0.70, P < .001) between problem avoidance behavior at the time of diagnosis and subsequent problem behavior (mean follow-up period after diagnosis: 1.3 + 1.1 years). The characteristics of spouses with avoidant behaviors included having wives with recurrence, having wives treated with anticancer drug therapy or total resection, and having their own experience of cancer. Covariance structure analysis revealed 2 factors related to the background of spouses with problem avoidance behavior: (1) having a sense of difficulty in coping (beta = 0.68, P < .001) and (2) having a poor marital relationship (beta = -0.27, P < .001).Conclusions: Our findings suggest that problem avoidance behavior among healthy male partners of breast cancer patients is common and correlates with difficulty coping and a poor marital relationship. It is important to address both the problem avoidance behavior itself and to support couples early, before this behavior surfaces. [ABSTRACT FROM AUTHOR]

Objective:The primary end points of this analysis were to explore 1) the practices of prognostic disclosure for patients with cancer and their family members in Japan, 2) the person who decided on the degree of prognosis communication, and 3) family evaluations of the type of prognostic disclosure.Method:Semistructured face-to-face interviews were conducted with 60 bereaved family members of patients with cancer who were admitted to palliative care units in Japan.Results:Twenty-five percent of patients and 75% of family members were informed of the predicted survival time of the patient. Thirty-eight percent of family members answered that they themselves decided on to what degree to communicate the prognosis to patients and 83% of them chose not to disclose to patients their prognosis or incurability. In the overall evaluation of prognosis communication, 30% of the participants said that they regretted or felt doubtful about the degree of prognostic disclosure to patients, whereas 37% said that they were satisfied with the degree of prognostic disclosure and 5% said that they had made a compromise. Both in the “prognostic disclosure” group and the “no disclosure” group, there were family members who said that they regretted or felt doubtful (27% and 31%, respectively) and family members who said that they were satisfied with the degree of disclosure (27% and 44%, respectively).Significance of results:In conclusion, family members assume the predominant role as the decision-making source regarding prognosis disclosure to patients, and they often even prevent prognostic disclosure to patients. From the perspective of family members, any one type of disclosure is not necessarily the most acceptable choice. Future surveys should explore the reasons why family members agree or disagree with prognostic disclosures to patients and factors correlated with family evaluations. [ABSTRACT FROM PUBLISHER]

Background: The primary goals of this analysis were to explore the pros and cons of prognostic disclosure to patients and their families from the bereaved family's point of view. Methods: Semistructured interviews were conducted with 60 bereaved family members of patients with cancer in Japan. Results: There were eight categories of influence related to the disclosure of prognosis to the family, including pros (e.g., ' Enabling mental preparedness for the patient's death') and cons (e.g., 'Being distressed by acknowledging the patient's prognosis') ; and seven categories of influence of not disclosing the prognosis to family, including pros (e.g., ' Being able to maintain hope') and cons (e.g., 'Being prevented from providing adequate care for the patient'). There were also nine categories of influence related to the disclosure of prognosis to patients (e.g., ' Enabling various discussions regarding death with the patient') , and eight categories of influence related to not disclosing the prognosis to patients (e.g., ' Maintaining the patient's hope'). Conclusions: Although prognostic disclosure to family members can contribute to psychological distress and hopelessness, at the same time, it has the potential to prepare them for the future both emotionally and practically, and also to make the time until the patient's death as meaningful as possible. It is useful for physicians to introduce pros and cons of prognostic disclosure to family members at the time of decision making, to understand the family members' psychological state, and to provide support considering pros and cons whether or not they disclosed prognosis. [ABSTRACT FROM AUTHOR]

Significant others play an important role in providing support in patients’ lives, but some types of support negatively affect the patients. This study was conducted in early-stage breast cancer patients to examine the structure of support, which was provided by their significant others and assessed negatively by the patients, and to identify negative support relating to the psychological adjustment of these patients. Thus, we first conducted interviews among 28 breast cancer patients to identify these support items assessed as negative; next, we conducted a questionnaire survey using the resulting items in 109 postoperative patients who had early-stage breast cancer. We performed exploratory and confirmatory factor analyses and obtained a valid second-order factor structure, including superordinate factors (excessive engagement, avoidance of problems and underestimation) and subordinate factors (overprotection, encouragement and management). Among these factors, the avoidance of problems was the only factor to be negatively associated with psychological adjustment of the patients, suggesting that these patients receive problem-avoiding support. The results of our study suggest that such problem-avoiding support from significant others can be counter-productive and potentially worsen the psychological adjustment of breast cancer patients. [ABSTRACT FROM PUBLISHER]

Background: This study explores the distribution of public awareness, knowledge of availability, and readiness for palliative care services, and the perceived reliability of information resources as part of a nationwide palliative care implementation intervention in Japan (Outreach Palliative Care Trial of Integrated Regional Model [OPTIM]). Methods: A cross-sectional anonymous questionnaire survey was conducted, and 3984 responses were used in the final analysis. Results: A total of 63.1% of respondents admitted having no knowledge about palliative care, while 0.5% of respondents were using palliative care services. Respondents who knew about palliative care services, yet did not know about their availability were 18.6% of all respondents. Respondents who had cancer-related experiences were more likely to be aware of palliative care compared to the general population and availability of palliative care services. Only awareness of palliative care was significantly associated with two typical images, while cancer-related experiences were not. Conclusion: Findings show that the public awareness of palliative care services and their availability is insufficient, and cancer-related experiences affect awareness of cancer palliative care but not directly related to typical images for palliative care such as care for patients close to death. [ABSTRACT FROM AUTHOR]

Background: In order to improve the quality of palliative care, we can learn from bereaved families who were dissatisfied with the care they received. The primary aim of this study was to explore why bereaved families were dissatisfied with specialized inpatient palliative care. Methods: This qualitative study formed part of a nationwide questionnaire survey administered to 1225 bereaved family members of cancer patients who died in certified palliative care units in Japan. The participants were 22 consecutive family members who reported a greater need for improvement in care. Data were analysed by the content analysis. Results: The reasons that the bereaved families listed are classified into 27 categories and seven themes: (1) lack of perceived support for maintaining hope; (2) lack of perceived respect of individuality, especially in attitudes toward death; (3) perceived poor quality of care, especially psychological care, not being treated with dignity and inadequate explanation from physicians; (4) inadequate staffing and equipment, especially physician availability; (5) unavailability of timely administration; (6) lack of accurate information about palliative care units; and (7) family's practical and economic burden. Conclusions: This study identified the multiple sources of dissatisfaction with specialized inpatient palliative care for bereaved families. These findings could be useful in developing a more desirable system of specialised inpatient palliative care. [ABSTRACT FROM AUTHOR]

• Self-defining memories (SDMs) were recalled twice an interval of one year. • Positive SDMs were recalled more than negative ones. • Higher working memory was associated with higher SDMs vividness and repeated recalled of SDMs. • Cognitive functions (verbal comprehension, perceptual reasoning, working memory, and processing speed) were not associated with the emotional valence of SDMs. • Serotonin transporter 5-HTTLPR polymorphism may be a plasticity factor that predicts positive outcomes in positive situations. The present study aimed to evaluate the pleasantness bias and fading affect bias in self-defining memories (SDMs) and to examine the relationship between their emotional valence of SDMs and cognitive function and serotonin transporter polymorphisms (5-HTTLPR) with a prospective longitudinal method. Ninety-two older adults recalled SDMs twice at an interval of one year (T1 and T2). The results showed a pleasantness bias and a fading affect bias in SDMs. The higher the working memory was, the higher the vividness of SDMs and the higher the concordance rate of SDMs between T1 and T2. Meanwhile, cognitive performance had no effect on the emotional valence of SDMs. Additionally, the repeatedly recalled SDMs in the S/S allele carriers of the 5-HTTLPR polymorphism changed with a lower negative valence at T2 than at T1. The 5-HTTLPR polymorphism may be a plasticity factor that predicts positive outcomes in positive situations. [ABSTRACT FROM AUTHOR]

Introduction: Cancer survivors have reduced health-related quality of life (HRQOL) due to impaired daily functioning. In addition, daily stress leads to worsening oxidative stress. The purpose of this study is to investigate the efficacy of laughter therapy on HRQOL and oxidative stress in cancer survivors., Methods: This before-and-after study asked cancer survivors to watch a 15-minute or longer comedy video over a four-week period to assess the Functional Assessment of Cancer Therapy-General (FACT-G), EuroQOL 5 dimension 3-level (EQ-5D-3L), Hospital Anxiety and Depression Scale (HADS), biological Antioxidant Potential (BAP), Reactive Oxygen Metabolites-derived compounds (d-ROMs), Oxidative Stress Index (OSI), and the antioxidant/oxidative stress ratio., Results: The nonparametric Friedman test showed significant increases from baseline in FACT-G and EQ-VAS scores and significant decreases in HADS-Anxiety and HADS-Depression scores. Post hoc analyses showed that these items commonly differed significantly at baseline versus three and four weeks after Bonferroni correction. T-test results in the biological analysis revealed small and moderate effects with significant differences in BAP (p < 0.01, d = 0.49), OSI (p = 0.03, d = 0.33), and BAP/d-ROMs (p < 0.01, d = 0.51)., Conclusion: These results suggest that daily comedy viewing may be an effective intervention to improve quality of life and antioxidant capacity in cancer survivors. Considering its safety, convenience, and low cost, it should be considered a high-value intervention for cancer survivors., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sakamoto et al.)

Objective: We investigated the effects of age on mood and mental health-mediated emotion regulation, such as cognitive reappraisal and expressive suppression, and examined whether these relationships differ according to gender. Method: We recruited 936 Japanese participants. They comprised six age groups ranging from 20 to 70 years old, with 156 participants in each age group and equal numbers of men and women. Results: Structural equation model analysis showed that older participants were more likely to use cognitive reappraisal, further enhancing positive mood and reducing negative mood, whereas, age did not affect expressive suppression. Moreover, expressive suppression had a smaller impact on mood than cognitive reappraisal. A multi-group analysis showed significant gender differences. In men, cognitive reappraisal increased with age and influenced mood more positively than in women. Discussion: Our findings indicated gender differences in aging effects on emotion regulation. We discussed about these results from the cognitive process, motivation to emotion regulation, and cultural differences., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The purpose of this study was to investigate the association between depression symptoms 1 year after onset and subsequent cardiovascular events among survivors of myocardial infarction (MI)., Methods and Results: The participants were recruited from respondents to a district-based survey known as the Osaka Acute Coronary Insufficiency Study. Of 4,271 eligible MI patients, 1,951 completed the Zung Self-Rating Depression Scale (SDS) at their 1-year follow-up examination. After excluding patients who experienced cardiovascular events within 1 year, the data for the remaining 1,307 male patients and 280 female patients were analyzed. Among male patients, depression status at 1 year after onset of MI was significantly related to risk of subsequent cardiovascular events throughout the follow-up period (median 2.9 years). The male patients in the top vs. bottom tertiles of SDS scores (top tertile being ≥42) had a multivariable-adjusted hazard ratio (HR) of 1.67 (95% confidence interval (CI) 1.01-2.77, P=0.04), and a 1-SD increment in SDS score was significantly related to a heightened risk of cardiovascular events, with a multivariable-adjusted HR of 1.30 (95%CI 1.07-1.58, P=0.01). There were no significant associations between SDS scores and cardiovascular events among female patients., Conclusions: Depression symptoms 1 year after onset of MI are a significant predictor of subsequent cardiovascular events for male patients.