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Background: The comparative effectiveness study (ClinicalTrials.gov, NCT03016403) assessed the effects of a stepped‐care intervention versus usual care on mental health outcomes, including anxiety, depression, coping self‐efficacy, emotional distress (anxiety and depression combined), health‐related quality of life (HRQoL), and perceived stress among underserved patients (i.e., low‐income, uninsured, underinsured) with lung cancer (LC) and head‐and‐neck cancer (HNC). Methods: In a randomized controlled trial, we investigated if 147 patients who received the stepped‐care intervention had better mental health outcomes compared to 139 patients who received usual care. Using an intent‐to‐treat approach, we analyzed outcomes with linear mixed models. Results: For the primary outcomes estimated mean differences (denoted by "Δ"), depression (Δ = 1.75, 95% CI = 0.52, 2.98, p = 0.01) and coping self‐efficacy (Δ = −15.24, 95% CI = −26.12, −4.36, p = 0.01) were better for patients who received the intervention compared to patients who received usual care, but anxiety outcomes were not different. For secondary outcomes, emotional distress (Δ = 1.97, 95% CI: 0.68, 3.54, p =< 0.01) and HRQoL (Δ = −4.16 95% CI: −7.45, −0.87, p = 0.01) were better for patients who received the intervention compared to usual care patients, while perceived stress was not different across groups. Conclusions: The stepped‐care intervention influenced depression and coping self‐efficacy, important outcomes for patients with acute illnesses like LC and HNC. Although differences in emotional distress met the minimally important differences (MID) previously reported, depression and HRQoL were not above the MID threshold. Our study is among a few to report differences in mental health outcomes for underserved LC and HNC patients after receiving a psychological intervention. ClinicalTrials.gov identifier: NCT03016403. [ABSTRACT FROM AUTHOR]

Background: Respiratory problems have been shown to be associated with the development of panic anxiety. Family members play an essential role for children to emotionally manage their symptoms. This study aimed to examine the relation between severity of respiratory symptoms in children with asthma and separation anxiety. Relying on direct observation of family interactions during a mealtime, a model is tested whereby family interactions mediate the relation between asthma severity and separation anxiety symptoms. Methods: Sixty-three children (ages 9-12 years) with persistent asthma were interviewed via the Diagnostic Interview Schedule for Children IV; family interactions were assessed via direct observation of a mealtime; primary caregivers completed the Childhood Asthma Severity Scale; youth pulmonary function was ascertained with pre- and post-bronchodilator spirometry; adherence to asthma medications was objectively tracked for six weeks. Results: Poorer pulmonary function and higher functional asthma severity were related to higher numbers of separation anxiety symptoms. Controlling for medication adherence, family interaction patterns mediated the relationship between poorer pulmonary function and child separation anxiety symptoms. Conclusions: Family mealtime interactions may be a mechanism by which respiratory disorders are associated with separation anxiety symptoms in children, potentially through increasing the child's capacity to cognitively frame asthma symptoms as less threatening, or through increasing the child's sense of security within their family relationships.

Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that can lead to early-onset chronic obstructive pulmonary disease (COPD). The objective of this study was to examine the impact of age on psychological and clinical outcomes among individuals with AATD-associated COPD. 468 individuals with AATD-associated COPD (age 32-84 at baseline) completed questionnaires at baseline, 1- and 2-year follow-up. Age was examined as a predictor of depression, anxiety, health-related quality of life, and breathlessness at all three time points using linear mixed models. Age was associated with anxiety (b = -0.09, SE = 0.02, p < 0.001) and health-related quality of life (b = -0.29, SE = 0.09, p < 0.001). Age also had a statistically significant interaction with relationship status when predicting depression, health-related quality of life, and breathlessness. Among individuals who were single, younger age was associated with more symptoms of depression (b = -0.08, SE = 0.03, p < 0.01), worse health-related quality of life (b = -0.61, SE = 0.16, p < 0.001), and more breathlessness (b = -0.023, SE = 0.009, p < 0.01) throughout the 2-year study. Age was not associated with these three outcomes among individuals who were married/part of an unmarried couple. Results suggest that individuals who develop a chronic illness at a young age, particularly those who are single, may be more likely to have worse psychological and clinical outcomes. Keywords Age * Relationship status * Chronic obstructive pulmonary disease * Depression * Anxiety * Clinical outcomes, Introduction Timing of illness is a central component of the experience of living with a chronic illness. Older individuals are more likely than younger individuals to expect illness as a [...]

Investigates psychometric properties and overall utility of Family-of-Origin Scale. Concludes that, although much of the recent criticism of this instrument may be justified, with changes (primarily in interpretation) the instrument remains useful. Taking this measure as an example, discusses problems inherent in the use of individual self-report data as indicators of family systems constructs. (Author/NB)

Explores how individuals' conceptions of their family vary across stages of family development. Compares several hypotheses of how key interpersonal relationships shape individuals' intrapsychic experience of their family. Finds scant support for socialization theory but considerable support for social transaction theory. (SR)

Introduces a special issue of "Communication Research," which examines (both quantitatively and qualitatively) how processes within individuals influence communication within marital and family life. (SR)

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1545-5300.2008.00243.x Byline: FREDERICK S. WAMBOLDT (*,[dagger]) Author Affiliation: (*)Head, Division of Psychosocial Medicine and Professor of Medicine, National Jewish Medical and Research Center, Denver, CO ([dagger])Professor of Psychiatry, University of Colorado at Denver and Health Sciences Center, Denver, CO. Article note: Correspondence concerning this article should be addressed to Frederick S. Wamboldt, National Jewish Medical and Research Center, 1400 Jackson St, Denver, CO 80206. E-mail: wamboldtf@njc.org