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This research tested the hypothesis that emotional crying facilitates coping and recovery, specifically through physiological changes that occur during crying. Female undergraduate students (N = 197) were randomly assigned to either a sad or neutral condition using short videos. Sad videos were selected for their extreme emotion elicitation. We predicted that compared to those who did not cry to the stimuli and those who were exposed to neutral videos, people who cried would (a) be able to withstand a stressful task for longer; (b) show lower levels of cortisol following crying and exposure to the stressor; and (c) have faster recovery (i.e., return to baseline levels of affect). The final groups consisted of the neutral group (n = 65), sad criers (n = 71), and sad noncriers (n = 61). After a 5-min baseline period, participants watched either the sad or neutral videos for 17 min and then completed a physical stressor (cold pressor test). Heart rate and respiration were continuously recorded, whereas salivary samples for cortisol were taken at 4 separate time points during testing. Analyses revealed no differences between the 3 groups in time withstanding the stressor or cortisol changes. Respiration rate, however, increased in the neutral group and noncriers while watching the videos, with criers' respiration remaining stable. Furthermore, heart rate was found to decelerate just before crying, with a return to baseline during the first crying period. These results suggest that crying may assist in generally maintaining biological homeostasis, perhaps consciously through self-soothing via purposeful breathing and unconsciously through regulation of heart rate. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

ObjectiveNostalgia is a sentimental longing for one's past. We examined the hypotheses (rooted in attachment theory and research) that nostalgia prone individuals, by virtue of their greater attachment security, are more empathic and enact more prosocial behavior.MethodIn five studies, testing 1,923 participants (Nrange = 132–823, 52.42% women, Agerange = 8–90 years), we measured nostalgia proneness and affective empathy. Additionally, we measured cognitive empathy in Study 3, attachment security in Studies 4–5, and prosocial behavior in Study 5. ResultsNostalgia proneness was positively related to affective empathy among younger and older adults (Studies 1, 3–5) and among children (Study 2). This association was stronger for affective empathy than cognitive empathy (Study 3). Also, attachment security mediated the relation between nostalgia proneness and affective empathy (Studies 4–5). Finally, nostalgia prone individuals were more likely to engage in prosocial behavior, and this relation was serially mediated by attachment security and affective empathy (Study 5).ConclusionThe findings establish the empathic and prosocial character of nostalgia prone individuals, and clarify their personality profile.

Emotion dysregulation and hyperreactivity are considered central features of Borderline Personality Disorder (BPD). We assumed that such emotion dysregulation is also reflected in increased crying behavior of these patients and, consequently, hypothesized that BPD patients (N = 62), compared to Cluster C personality disorder patients (Cluster C-PD; N = 25) and non-patients (N = 54), would show higher scores on crying measures. To evaluate crying behavior, we used a set of specially designed tools. Compared to non-patients, BPD patients showed the anticipated higher crying frequency despite a similar crying proneness and ways of dealing with tears. They also reported less awareness of the influence of crying on others. However, Cluster C-PD patients showed a very similar pattern of findings. Overall, our results suggest that the increased crying of BPD patients likely results from environmental factors or the misperception of situations, rather than from stable traits. Remarkable is that the observed discrepancies in crying behavior compared to non-patients seem to be similar for Cluster-C PDs and BPD.

According to Linehan (1993), emotion dysregulation is a central feature of borderline personality disorder (BPD). We hypothesized that patients with BPD are emotionally hyperresponsive. For BPD treatment, it is important to evaluate this hypothesis, because, if it is supported, therapeutic interventions could be designed to help patients to better manage hyperemotional reactions. We investigated the subjective reactions (in terms of valence and arousal) of patients with BPD to visual emotional stimuli of the International Affective Picture System (IAPS). We hypothesized that, compared to patients with Cluster-C personality disorders and non-patients, BPD patients would show higher scores on the arousal dimension and higher negative scores on the valence dimension when rating IAPS pictures with varying degrees of arousal and valence. Ratings of valence and arousal for 40 IAPS pictures were collected from 39 borderline personality disorder (BPD), 36 patients diagnosed with Cluster-C personality disorders (PD), and a group of 226 non-patients. Contrary to expectations, BPD patients did not differ from the non-patients. This indicates that their self-report scores do not reflect hypersensitivity. We found that patients with BPD showed lower scores on arousal than Cluster-C PD patients. The scores on valence suggested that Cluster-C PD patients also experienced more positive emotions than BPD patients.

The goal of this clinical practice review is to assess the current state of the theoretical and empirical literature on emotional crying (i.e., crying in response to an emotional stimulus), a topic that has received surprisingly limited attention of behavioral scientists and clinicians. Although the empirical research on emotional crying remains in a nascent state, we draw upon the existing scientific knowledge to provide preliminary suggestions for clinicians on how to interpret and respond to crying in clinical contexts. We also identify research gaps and provide recommendations for further research to improve our understanding of this intriguing and still poorly understood human behavior. We suggest that a better understanding of individual differences in crying behavior and the postulated intraindividual and interindividual functions of crying is of critical importance for clinicians, given its frequent occurrence and notable associations with emotional and social functioning. An improved characterization of this important phenomenon will lead to improvements in clinical assessment, treatment planning, and psychotherapy interventions. Clinical Impact Statement—Question: We review the state of the empirical literature on human crying behavior, with a focus on crying of both patients and therapists in the clinical setting. Findings: Findings may help guide how clinicians interpret and respond to crying in the clinical setting. Meaning: Generally crying of therapists or patients appears to be beneficial in a clinical context, but this seems to depend on a number of contextual factors. Next Steps: As current research on crying in the context of clinical assessment and psychotherapy is still very limited, further research is needed to fully understand how crying of patients and therapists impacts the therapeutic process, as well as how crying behavior manifests in various forms of psychopathology.

In two experimental studies, we explored the role of attachment in predicting emotional reactivity after frustration induction. In the first study, using a cognitive frustration task, we examined in a college sample (N = 134) how attachment styles related to the experience and expression of emotions after frustration induction. In the second study, we investigated in college students (N = 198) the effect of conscious priming of the secure base schema on mood disturbance after the performance of a cognitive frustration task. Results showed that individuals experienced and expressed emotions after frustration induction independent of their attachment styles. Conscious priming of the secure base script attenuated self-reported emotional reactivity after frustration induction independent of individuals' attachment styles. These findings suggest that the mechanism of attachment-related emotional reactivity might not pertain to frustration during an unsolvable cognitive task, but that the activation of the sense of having a secure base is useful in reducing mood disturbance in the context of a frustrating performance task.

We examined several aspects of the crying experiences of physicians and medical interns, including the most common reasons to cry in the workplace, and their perceptions of and attitudes towards crying in the workplace and in the presence of a patient. A sample of Dutch physicians and medical interns (Nphysicians = 1068 and Nmedical interns = 302 and for the full version Nphysicians = 776 and Nmedical interns = 181) completed an especially designed anonymous online questionnaire about experiences with crying in the workplace, and perceptions of and attitudes towards crying in the workplace and in the presence of patients. Crying is a rather frequent behavior among physicians, in particular when they have to deal with the severe suffering of patients and their relatives. We found a considerable variety in the attitudes and perception of crying in the work setting, although there was also much agreement that crying in the presence of a patient is only appropriate if it is over the condition of the patient. Physicians reported a slightly more positive attitude and a stronger need for more attention to this topic in training and education than medical interns. Crying in the medical setting is a common, though understudied phenomenon. There is a strong need for further research on this topic in order to understand it better and how and when it might interfere with or facilitate with the therapeutic process. We strongly feel that currently the time is ripe for this topic because in particular the physicians expressed a greater need for more attention to this topic in training and the medical interns showed signs of, perhaps unhealthy, suppression of their emotions.

Earlier research found that the mere sight of tears promotes the willingness to provide support to the person shedding the tears. Other research, however, found that deliberate responses towards tearful persons could be more negative as well. We think this is because tears have ambivalent effects on person perception: We predicted that tearful people are seen as warmer, but also as less competent. In three studies, we asked participants (total N = 1,042) to form their impression of someone based on a picture. The depicted person either displayed visible tears, or the tears had been digitally removed. Tearful individuals were perceived as being warmer, but also as less competent. In Study 2, we also added a measure of perceived sadness. Seeing a tearful face increased perceived sadness, and this (partially) explained the reduction in perceived competence of the target person. There was no such indirect effect of the tear on perceived warmth via perceived sadness. Study 3 found that people would be more likely to approach a tearful person to offer help than a tearless individual. At the same time, tearful individuals would be more likely to be avoided in situations in which the observer needs assistance for an important task.

This study examined dimensions of crying and its relations with ocular dryness and mental well-being in patients with Sjo¨gren’s syndrome, a systemic autoimmune disease with dryness as primary symptom. Three-hundred patients with Sjo¨gren’s syndrome completed questionnaires on crying, dryness, and well-being. The crying questionnaire revealed four dimensions: ‘‘Cryability’’ (comprising both crying sensibility and ability to cry), Somatic consequences, Frustration, and Suppression. Compared to 100demographically-matched control participants from the general population, patients scored low on Cryability and high on Somatic consequences and Frustration. The crying dimensions generally showed significant but weak associations with ocular dryness and mental well-being in patients. This is the first quantitative study indicating that crying problems are more common in patients with Sjo¨gren’s syndrome than in the general population. Perhaps,patients who experience problems with crying could be helped to rely on other ways of expressing emotions than crying in tear-inducing situations.

IntroductionDespite consistently high discontinuation rates due to withdrawal of consent (WOC) and insufficient therapeutic effect (ITE) in schizophrenia trials, insight into the underlying factors contributing to poor satisfaction with treatment and dropout is limited. A better understanding of these factors could help to improve trial design and completion rates.MethodsUsing data from 1,136 trial participants with schizophrenia or schizoaffective disorder, we explored associations between predictor variables with (1) dropout due to WOC and ITE and (2) satisfaction with treatment among patients and investigators by means of hierarchic multiple regression analyses.ResultsITE was associated with poor clinical improvement, poor investigator satisfaction with treatment, and poor patient insight into their own disease, whereas WOC only showed a meaningful association with poor patient satisfaction with treatment. Investigator satisfaction with treatment appeared most strongly associated with Positive and Negative Syndrome Scale (PANSS) positive factor endpoint scores, whereas patient satisfaction with treatment was best predicted by the endpoint score on the PANSS emotional distress factor. The occurrence of severe side effects showed no meaningful association to satisfaction with treatment among investigators and patients, and neither did a patient’s experienced psychopathology, nor their self-rating of functional impairment.ConclusionsWhereas trial discontinuation due to ITE is associated with poor treatment effectiveness, a patient’s decision to withdraw from an antipsychotic trial remains unpredictable and may occur even when the investigator observes a global clinical improvement and is satisfied with the treatment.

Producing emotional tears is a universal and uniquely human behavior. Until recently, tears have received little serious attention from scientists. Here, we summarize recent theoretical developments and research findings. The evolutionary approach offers a solid ground for the analysis of the functions of tears. This is especially the case for infant crying, which we address in the first part of this contribution. We further elaborate on the antecedents and (intra- and interpersonal) functions of emotional tears in adults. The main hypothesis that emerges from this overview is that crying evolved as an emotional expression that signals distress and promotes prosocial behaviors in conspecifics. Further, shedding tears may influence the mood of the crier and his/her outlook on life primarily as a consequence of fulfillment of the proposed signaling function of tears. We also describe how cultural phenomena such as ritual weeping nicely fit within this framework, as they often aim to support a request for help to a powerful person or deity and promote social bonding.

Contains fulltext : 194063.pdf (Publisher’s version ) (Open Access) Emotional tears have been proposed to represent a robust affiliative signal whose main function is to promote the willingness to help the crying individual. However, little is known about the psychological mechanisms at the basis of such responses. To investigate whether tears facilitate approach relative to avoidance tendencies, we exposed participants (N = 77) to pictures of faces with and without visible tears, in two different approach–avoidance tasks. In the first task, participants were instructed to either move toward tearful faces and away from nontearful faces, or the other way around, by using a joystick. In the second task, participants made approaching or avoiding responses to tearful and nontearful faces by pressing buttons. The results suggest that tears facilitate behavior that reduces the distance between the observer and the crying person. However, while tears appear to promote approach relative to avoidance behavior, the current findings do not allow firm conclusions about whether tears specifically facilitate approach or rather block avoidance tendencies in observers, or whether they possibly have both effects. Findings are discussed in the context of tears’ ability to act as a prosocial stimulus that signals non-aggressive intentions, as well as in the context of the functional goals that predispose humans to approach or avoid crying individuals. 10 p.

OBJECTIVES: The present study investigated deficiencies in different components of emotional intelligence in borderline personality disorder (BPD).METHOD: The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Emotional Quotient Inventory (EQ-i) were used to assess EI dimensions. BPD patients (N = 85; 69 women; M = 33.6 years) were compared with Cluster C personality disorder (PD) patients (N = 39; 23 women; M = 36.6 years) and nonpatients (N = 69; 44 women; M = 35.6 years).RESULTS: Compared to the Cluster C PD patients and the nonpatient group, BPD patients displayed only deficits in their ability to understand emotions as measured with the Mayer-Salovey-Caruso Emotional Intelligence Test. The Emotional Quotient Inventory only revealed deficits in stress management in BPD patients compared to Cluster C PD patients.CONCLUSIONS: Our findings suggest that BPD patients have the ability to regulate emotions effectively, but they subjectively experience deficits in emotion regulation and therefore may not use this ability when they need it.

Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in “Activities &amp, Participation” were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in “Activities &amp, Participation” decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor “support and relationships” reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in “Environmental Factors” were significant predictors of relative variability in “Activities &amp, Participation”. It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness.

The production of emotional tears appears to be uniquely present in Homo Sapiens. Despite the ubiquity of this human behavior, research is only just beginning to uncover the neurobiological underpinnings of human emotional crying. In this paper, we review the current state of the literature investigating the neurobiological aspects of this uniquely human behavior, including neuroanatomical, neurochemical, and psychophysiological findings. To set the context for this review, we first provide a brief overview of the evolutionary background and functions of tearful crying. Despite an accumulating understanding of the neurobiology of human emotional crying, the primary sources of information are currently from animal studies and observations in neurological patients suffering from pathological crying. Currently, most of the research on the neurobiology of crying in humans has focused on autonomic physiological processes underlying tearful crying, which may yield essential clues regarding the neural substrates of the production of crying behavior and its effects on the crier. Further challenges in elucidating the neurobiology of crying involve the complexity of crying behavior, which includes vocalizations, tear production, the involvement of facial musculature, subjective emotional experience, emotion regulatory behaviors, and social behaviors. Future research is needed to comprehensively characterize the neurobiology of this intriguing and complex human behavior.

Objective: To evaluate the effect of haptotherapy on severe fear of childbirth in pregnant women.Design: Randomized controlled trial.Setting: Community midwifery practices and a teaching hospital in the Netherlands.Population or Sample: Primi- and multigravida, suffering from severe fear of childbirth (N=134).Methods: Haptotherapy, psycho-education via Internet and care as usual were randomly assigned at 20-24weeks of gestation and the effects were compared at 36weeks of gestation and 6weeks and 6months postpartum. Repeated measurements ANOVA were carried out on the basis of intention to treat. Since there were crossovers from psycho-education via Internet and care as usual to haptotherapy, the analysis was repeated according to the as treated principle.Main outcome measures: Fear of childbirth score at the Wijma Delivery Expectancy/Experience Questionnaire.Results: In the intention to treat analysis, only the haptotherapy group showed a significant decrease of fear of childbirth, F(2,99)=3.321, p=.040. In the as treated analysis, the haptotherapy group showed a greater reduction in fear of childbirth than the other two groups, F(3,83)=6.717, pConclusion:Haptotherapy appears to be more effective in reducing fear of childbirth than psycho-education via Internet and care as usual.

Background: Maternal postpartum distress is often construed as a marker of vulnerability to poor parenting. Less is known, however, about the impact of postpartum distress on parenting an infant born prematurely. The present study investigated whether high distress levels, which are particularly prevalent in mothers of preterm born infants, necessarily affect a mother’s quality of parenting. Method: Latent Class Analysis was used to group mothers (N = 197) of term, moderately, and very preterm born infants, based on their levels of distress (depression, anxiety, and PTSD symptoms) at one month postpartum, and their quality of parenting at one and six months postpartum. Parenting quality was assessed on the basis of maternal interactive behaviors (sensitivity, intrusiveness, and withdrawal) using observations, and maternal attachment representations (balanced, disengaged, or distorted) using interviews. Results: A 5-Class model yielded the best fit to the data. The first Class (47%) of mothers was characterized by low distress levels and high-quality parenting, the second Class (20%) by low distress levels and low-quality parenting, the third Class (22%) by high distress levels and medium-quality parenting, the fourth Class (9%) by high distress levels and high-quality parenting, and finally the fifth Class (2%) by extremely high levels of distress and low-quality parenting. Conclusions: While heightened distress levels seem inherent to preterm birth, there appears to be substantial heterogeneity in mothers’ emotional responsivity. This study indicates that relatively high levels of distress after preterm birth do not necessarily place these mothers at increased risk with regard to poor parenting. Conversely, low distress levels do not necessarily indicate good-quality parenting. The results of the present study prompt a reconsideration of the association between postpartum distress and parenting quality, and challenge the notion that high levels of maternal distress always result in low-quality parenting practices. The final version of this research has been published in Infant Behaviour and Development. © 2017 Elsevier

Aim Reward sensitivity affects individuals’ motivation to engage in goal-directed behavior. Other concepts, critical for reward appraisal, that potentially influence activity participation encompass delay discounting and anhedonia. The aim of this study was to test the hypothesis that anhedonia and delay discounting influence the relationship between reward sensitivity and activity engagement. Methods In total, 37 inpatient patients with an alcohol use disorder (AUD) and 37 matched healthy controls completed the behavioral activation system scale (BAS scale), the Pleasant Activities List (PAL), the Snaith–Hamilton Pleasure Scale (SHAPS) and the Delay Discounting Task (DDT). Results Patients differed from controls on SHAPS, DDT-k, PAL substance-related activities (SRA), but not BAS and PAL non-substance-related activities (non-SRA). Correlational analyses revealed a strong correlation between BAS and PAL non-SRA in both patients (r = 0.53) and controls (r = 0.47), but also with PAL-SRA in patients (r = 0.40), although not controls (r = 0.09). BAS was negatively correlated with SHAPS in both groups and with DDT in controls. SHAPS was negatively linked to PAL non-SRA in both groups. The BAS-PAL non-SRA relationship was influenced by discount rates in controls. Conclusion A strong link exists between reward sensitivity and engagement in non-SRA in both groups. Delay discounting affects the reward sensitivity and non-SRA association in healthy controls, while anhedonia did not impact the association between reward sensitivity and engagement in (non-)SRA in both conditions.

Background There is a growing awareness that the treatment of patients with substance use disorders (SUDs) should target increasing patients’ involvement in alternative pleasant reinforcers that compete with the reinforcing effects of substance use. The present cross-sectional study sought to identify factors that promote or impede engaging in pleasant activities. Methods Patients with SUDs ( N = 265) were assessed at treatment entry on sociodemographic characteristics, primary type of substance (ie, alcohol or illicit drugs), addiction severity, craving, personality factors, and psychiatric distress. Results Regression analyses identified dissimilar predictor sets underlying frequency, enjoyability, and cross-product ratings, highlighting the multifaceted behavioral nature of activity engagement. Personality measures showed the strongest associations with patients’ activity engagement, with extraversion as the key predictor. Conclusions The present findings emphasize the complexity of patients’ involvement in pleasant non–substance-related activities and further investigation is necessary to gain more insight into the underlying mechanisms of activity engagement.

Crying is a unique form of human emotional expression that is associated with both positive and negative evocative antecedents. This article investigates the psychometric properties of a newly developed Crying Proneness Scale by examining the factor structure, test-retest reliability, and theoretically hypothesized relationships with empathy, attachment, age, and gender. Based on an analysis of data provided by a Dutch panel (Time 1: N = 4,916, Time 2: N = 4,874), exploratory and confirmatory factor analyses suggest that crying proneness is a multidimensional construct best characterized by four factors called attachment tears, societal tears, sentimental/moral tears, and compassionate tears. Test-retest reliability of the scale was adequate and associations with age, gender, empathy, and attachment demonstrated expected relations. Results suggest that this scale can be used to measure crying proneness, and that it will be useful in future studies that aim to gain a better understanding of normal and pathological socioemotional development.

We investigated the animal and human baby schema effect (BSE) in relation to gender, parental status, and individual features. In three, independent online surveys, conducted during three consecutive years, (Ntotal = 1389), ratings of photographs of human and animal infants as well as of adults, sociodemographic variables (age, gender, parental status) and personality attributes (empathy, attachment, interpersonal closeness, narcissism, and need to belong) were assessed. We demonstrated that humans are sensitive to the baby schemata of both humans and animals and that both are weakly positively correlated. BSE is positively associated with female gender and (affective) empathy. Higher interpersonal closeness and need to belong were additionally connected specifically to the human BSE. In contrast, narcissism and insecure attachment were not related to the BSE, suggesting a robustness of this phenomenon to possible negative influences of these two personality attributes.

The present study investigated emotional intelligence (EI) in borderline personality disorder (BPD). It was hypothesized that patients with BPD (n = 61) compared with patients with other personality disorders (PDs; n = 69) and nonpatients (n = 248) would show higher scores on the ability to perceive emotions and impairments in the ability to regulate emotions. EI was assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test (Mayer, Salovey, and Caruso [New York: MHS, 2002]). As compared with the PD group and the nonpatient group, the patients with BPD displayed the anticipated deficits in their ability to understand, whereas no differences emerged with respect to their ability to perceive, use, and regulate emotions. In addition, a negative relationship was found between the severity of BPD and total EI score. However, this relationship disappeared when intelligence quotient was partialled out. These results suggest that BPD is associated with emotion understanding deficits, whereas temporary severity of BPD is associated with emotion regulation deficits.

The quality of life in patients with chronic pancreatitis (CP) is reduced due to their suffering of high levels of pain. It has been presented that quality of life can also be linked to religiosity and/or spirituality. The aim of this study is to assess the influence of religious practices on the quality of life and on the subjective level of pain in CP patients. Ninety-two patients (37 women and 55 men) with chronic pancreatitis were treated invasively for pain with neurolytic celiac plexus block (NCPB). The religiosity of the patients was recorded and served as a dichotomizer. Group 1 was for patients who claimed to have no contact with the church or to have very sporadic contact (N = 35 patients). Group 2 was for patients who claimed to have deep faith and were regular participants at church activities (N = 57 patients). Visual analogue scale was used to assess pain, while the quality of life was measured by using QLQ C-30 questionnaire adapted for chronic pancreatitis patients in Polish population. The patients were assessed prior to the pain-relieving intervention and subsequently 2 and 8 weeks after it. The intensity of pain was reduced in both groups significantly after performing the NCPB. Patients who declared a deep faith reported higher level of pain on the VAS scale prior to intervention than non-religious patients. Quality of life in both groups of patients significantly improved after NCPB. Following NCPB, global quality of life in patients who declared higher religiosity/church attendance was significantly higher (79.88) than for those patients who have no contact or sporadic contact with the church (44.21, P < 0.05). NCPB resulted in significant reduction of pain and increase in quality of life in both groups of patients with CP. Nevertheless, in the group declaring higher religiosity/church attendance, reported pain was higher, but, despite that, quality of life better. It may be concluded that religious practices might serve as an additional factor improving quality of life and coping in patients suffering from chronic pancreatitis. Keywords Chronic pancreatitis Pain Coping Religiosity Neurolytic coeliac plexus block NCPB Spirituality

Nostalgia, a sentimental longing for one's past, is an emotion that arises from self-relevant and social memories. Nostalgia functions, in part, to foster self-continuity, that is, a sense of connection between one's past and one's present. This article examined, in 6 experiments, how nostalgia fosters self-continuity and the implications of that process for well-being. Nostalgia fosters self-continuity by augmenting social connectedness, that is, a sense of belongingness and acceptance (Experiments 1-4). Nostalgia-induced self-continuity, in turn, confers eudaimonic well-being, operationalized as subjective vitality (i.e., a feeling of aliveness and energy; Experiments 5-6). The findings clarify and expand the benefits of nostalgia for both the self-system and psychological adjustment. (PsycINFO Database Record

Nostalgia, a sentimental longing or wistful affection for the past, is a predominantly positive and social emotion. Recent evidence suggests that nostalgia maintains psychological comfort. Here, we propose, and document in five methodologically diverse studies, a broader homeostatic function for nostalgia that also encompasses the maintenance of physiological comfort. We show that nostalgia--an emotion with a strong connotation of warmth--is triggered by coldness. Participants reported stronger nostalgia on colder (vs. warmer) days and in a cold (vs. neutral or warm) room. Nostalgia, in turn, modulates the interoceptive feeling of temperature. Higher levels of music-evoked nostalgia predicted increased physical warmth, and participants who recalled a nostalgic (vs. ordinary autobiographical) event perceived ambient temperature as higher. Finally, and consistent with the close central nervous system integration of temperature and pain sensations, participants who recalled a nostalgic (vs. ordinary autobiographical) event evinced greater tolerance to noxious cold.

'Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship (PROFILES)' is a registry for the study of the physical and psychosocial impact of cancer and its treatment from a dynamic, growing population-based cohort of both short and long-term cancer survivors. PROFILES contains a large web-based component and are linked directly to clinical data from the population-based Eindhoven cancer registry. This paper describes the rationale and design of PROFILES. The primary aims of studies that use the PROFILES registry are: (1) psychosocial risk and outcome assessment to identify patients at high risk for poor physical and mental health outcomes, (2) to analyse mediating mechanisms to better understand the biological and behavioural factors associated with cancer treatment outcomes, and (3) to evaluate physical and psychosocial care needs of cancer survivors. PROFILES is a tool that enables data collection management; from inviting patients to participation in studies, to collecting patient-reported outcomes data via web-based or mailed questionnaires and linking these data with clinical data. The availability of a control cohort of approximately 2000 persons from the general population who complete the same basic questionnaire annually will provide the opportunity to estimate the unique impact of cancer, beyond that of normal ageing and comorbidities. Raw data from the PROFILES registry will be available for non-commercial scientific research, subject to study question, privacy and confidentiality restrictions, and registration (www.profilesregistry.nl). (C) 2011 Elsevier Ltd. All rights reserved.

Purpose The Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2) has been developed as generic measure to assess suffering. The aim of this study was to evaluate the ability of this instrument to identify long-term cancer survivors with high levels of suffering who may need additional support. Methods 1299 cancer survivors completed the PRISM-R2, the Short Form Health Survey (SF-36), and the Quality of Life-Cancer Survivors questionnaire (QoL-CS). The PRISM-R2 distinguishes between the Self-Illness Separation (SIS) and Illness Perception Measure (IPM), both measuring aspects of suffering. Results 112 (9%) cancer survivors reported high suffering according to IPM. This group had a higher cancer stage at diagnosis, more cancer recurrences, more comorbidities, and were lower educated compared to people reporting less suffering. The PRISM-R2 could explain substantial amounts of variance (10–14%) in the psychological aspects of the SF-36 and QoL-CS. The IPM also discriminated statistically and clinically significant between high- and low-health status. Conclusion The PRISM-R2 proved to be able to discriminate between individuals with good and deteriorated levels of QoL. Further evaluation of its validity and screening potential is recommended.

In the present study, the decision making abilities of patients with substance use disorders were compared to thoseof healthy controls and, subsequently, the impact of psychiatric distress, behavioral inhibition, and impulsivity onIowa Gambling Task (IGT) performance were evaluated. A total of 31 patients and 31 matched healthy controlsperformed the IGT and completed the Symptom Checklist-90-Revised (SCL-90-R) and the Behavioral InhibitionSystem/Behavioral Activation System (BIS/BAS). The results confirmed that the patient group had severe impairmentson the IGT relative to the controls, which appeared to be virtually unrelated to the employed measures. It isconcluded that self-reported psychiatric symptoms, behavioral inhibition, and impulsivity have no impact on theIGT performance in this patient sample.

Objective: Chemotherapy-induced alopecia, a common and distressing side effect of chemotherapy, may be prevented by scalp cooling, which reduces toxicity of cytostatics in hair root cells. This is the first study designed to assess the effect of scalp cooling on well-being. Methods: A prospective multi-centre study was performed in 13 hospitals. Breast cancer patients treated with (N=98) and without (N=168) scalp cooling completed questionnaires (EORTC QLQ-C30 and EORTC-QLQ-BR23, BIS, MBA, HADS) before chemotherapy, and three weeks and six months after the last chemotherapy cycle. Results: Scalp cooling was effective in 52% of the cases. Alopecia was considered among the most distressing problems at all three moments of measurement. A trend towards higher well-being was found in successfully scalp-cooled patients, as indicated by a general better health-related quality of life and better body image, whereas unsuccessfully scalp-cooled patients reported lowest well-being. Conclusions: Scalp cooling contributes not only to the well-being of successfully scalp-cooled patients but also seems to cause additional distress when patients lose their hair despite scalp cooling. This might be related to disappointment due to alopecia despite scalp cooling or possibly to a general higher biological availability of cytostatics. We recommend additional support for patients when scalp cooling is not successful and to spend more effort to maximise the effectiveness of scalp cooling. Copyright © 2009 John Wiley & Sons, Ltd.

Background Evidence is accumulating for an association between psychosocial stress and elevated blood pressure. However, studies focusing on adaptive psychosocial factors are scarce. Purpose We examined the association between putatively adaptive psychosocial factors and home blood pressure in a population study in the Netherlands. Method Resting blood pressure was measured of 985 female and 777 male participants between 20 and 55 years of age in their home setting. Questionnaires assessing problem-focused coping (active coping), adaptive emotion-focused coping (positive reinterpretation) and social support were completed. Results When controlled for age, marital and socio-economic status, body mass index, parental history of hypertension, physical exercise, smoking, alcohol, coffee, and—in women—oral contraceptives, positive reinterpretation was associated with a lower prevalence of elevated home blood pressure (≥140/90 mmHg): OR = 0.60, 95% CI = 0.40–0.88 (P = 0.009). Although all three psychosocial variables were associated with both systolic and diastolic blood pressure level, in multivariable analyses, only the associations between systolic blood pressure and positive reinterpretation (β = −0.09, t = 3.25, P = 0.001) and active coping (β = 0.07, t = 2.65, P = 0.008) remained significant. Conclusion Independent of other factors, only positive reinterpretation of the situation appeared to be related to more favorable blood pressure levels.

Purpose: To obtain insight into the long-term (5- to 10-year) effects of prostate cancer and treatment on bowel, urinary, and sexual function, we performed a population-based study. Prostate-specific function was compared with an age-matched normative population without prostate cancer. Methods and Materials: Through the population-based Eindhoven Cancer Registry, we selected all men diagnosed with prostate cancer between 1994 and 1998 in the southern Netherlands. In total, 964 patients, alive in November 2004, received questionnaire; 780 (81 %) responded. Results: Urinary problems were most common after a prostatectomy; bowel problems were most common after radiotherapy. Compared with an age-matched normative population both urinary and bowel functioning and bother were significantly worse among survivors. Urinary incontinence was reported by 23-48% of survivors compared with 4% of the normative population. Bowel leakage occurred in 5-14% of patients compared with 2% of norms. Erection problems occurred in 40-74% of patients compared with 18% of norms. Conclusions: These results form an important contribution to the limited information available on prostate-specific problems in the growing group of long-term prostate cancer survivors. Bowel, urinary, and sexual problems occur more often among long-term survivors compared with a reference group and cannot be explained merely by age. Because these problems persist for many years, urologists should provide patients with adequate information before treatment. After treatment, there should be an appropriate focus on these problems. (C) 2009 Elsevier Inc.

This study describes the differences in short-term effects of health-related quality of life (HRQOL) in I-125 prostate brachytherapy patients who were treated with and without volume-reducing hormone therapy.Prostate cancer patients (N = 312) filled out questionnaires on HRQOL (European Organization of Research and Treatment of Cancer Quality of Life Questionnaire [EORTC-QLQ]-C30 and EORTC-QLQ-PR25) before treatment and 6 weeks and 3 months after treatment. HRQOL was compared between the two groups: Patients who were receiving brachytherapy (n = 233) and patients who were receiving brachytherapy with volume-reducing hormone therapy (n = 79). Duration of androgen ablation was 9 months, starting 3 months before I-125 implantation.After treatment, patients reported significant and clinically relevant decreased scores on the following subscales: Global health status, role functioning, social functioning, pain, insomnia, bowel symptoms and functioning, and treatment-related functions, regardless of the therapy they received. Results showed that prostate cancer patients receiving brachytherapy with volume-reducing hormone therapy also experienced lower treatment-related functions and lower sexual function. Significant time by treatment interaction effects were found for treatment-related functions. The subscale treatment-related functions was the only scale that showed a difference over time, between treatments, and time by treatment.The differences in HRQOL between brachytherapy and brachytherapy with volume-reducing hormone therapy are small; they both decrease HRQOL and increase treatment-related problems. A long-term prospective study on long-term effects on HRQOL is needed to obtain a more comprehensive view of the consequences of a specific treatment modality over time. Our results can help to identify the problems patients face after brachytherapy with or without hormone therapy; these problems deserve additional attention during the period of recovery.

This study evaluates posttraumatic growth, benefit finding and well-being, and their mutual association in a random sample of disease-free 10-year breast cancer survivors. The population-based Eindhoven Cancer Registry (ECR) was used to select all women diagnosed with breast cancer in 1993 in six hospitals. Of the 254 breast cancer survivors, 183 (72%) returned a completed questionnaire. Measures included the Posttraumatic Growth Inventory (posttraumatic growth), the Perceived Disease Impact Scale (benefit finding) and the CentERdata Health monitor (life satisfaction, health status and psychological well-being). Self-reported health status and psychological well-being were similar in survivors compared to general population norms, whereas life satisfaction was significantly higher among survivors. In addition, posttraumatic growth was seen in the following domains: relationships with others, personal strength and appreciation of life. The number of patients reporting benefit finding was high (79%, N = 145). Benefit finding showed a moderately positive correlation with posttraumatic growth. In addition, women who stated that their satisfaction with life was high reported higher levels of posttraumatic growth in comparison to women who did not. Radiotherapy was negatively associated with posttraumatic growth. Women with a higher tumour stage at diagnosis experienced less benefit finding in comparison to women with a lower tumour stage at diagnosis. The above results can help to identify those patients who will probably experience posttraumatic growth and benefit finding after cancer. However, it is important to be aware that the positive effects of cancer on a patient's life do not occur in all cancer patients and all phases of the disease trajectory.

Objective The aim of the present study was to explore the relationship among subjective illness impact, subjective well-being, and psoriasis severity as assessed by dermatologists. Furthermore, subjective well-being of psoriasis patients was compared to available norm data. Methods Fifty-nine psoriasis patients participated in this study. The following measures were administered: (a) the Pictorial Representation of Illness and Self Measure ‐ Revised (PRISM-R), yielding Self-Illness Separation (SIS), and Illness Perception Measure (IPM); (b) subjective health status; (c) life satisfaction, and (d) psychological well-being. In addition, the Psoriasis Area and Severity Index (PASI) was determined by dermatologists. Results Psoriasis patients scored significantly below the norm data on subjective health status and psychological well-being. No differences were found concerning life satisfaction. PASI failed to correlate significantly with any of the disease impact and subjective health measures. Neither did SIS correlate significantly with any of the subjective health measures, whereas IPM was negatively associated with subjective health status, life satisfaction, and psychologic well-being. In a regression analysis with PASI as the dependent measures, none of the subjective health measures showed up as a relevant predictor. Conclusion In comparison with the norm data, psoriasis patients report less subjective health status and well-being whereas their life satisfaction is not affected. There is no clear association among illness impact, subjective well-being, and illness severity as assessed by dermatologists.

Theorists have staked out two ostensibly opposing views of human crying as either an arousing behavior that signals distress or a soothing behavior that reduces arousal after distress. The present study examined whether these views of crying might be reconciled by attending to physiological changes that unfold over crying episodes. Sixty female students watched neutral and cry-eliciting films while autonomic physiology, including respiratory sinus arrhythmia and pre-ejection period, was assessed. Crying participants exhibited heart rate increases that rapidly subsided after crying onset. Crying onset was also associated with increases in respiratory sinus arrhythmia and slowed breathing. All crying effects subsided by 4 minutes after onset. It is possible that crying is both an arousing distress signal and a means to restore psychological and physiological balance, depending on how and when this complex behavior is interrogated.

We compared the health-related quality of life, impact of the disease, risk perception of recurrence and dying of breast cancer, and understanding of diagnosis of patients with ductal carcinoma in situ (DCIS) and invasive breast cancer 2-3 years after treatment. We included all women (N = 211) diagnosed with DCIS or invasive breast cancer TNM stage I (T1, N0, and M0) in three community hospitals in the southern part of The Netherlands in the period 2002-2003. After verifying the medical files, 180 disease free patients proved eligible for study entry, 47 of whom had DCIS and 133 stage I invasive breast cancer. one-hundred and thirty-five patients returned a completed questionnaire (75% response). No significant differences were found between women with DCIS and invasive breast cancer on the physical and mental component scale of the RAND SF-36, nor on the WHO-5, which assesses well-being. In contrast, women with DCIS reportedly had a better physical health, better sex life and better relationships with friends/acquaintances than women with invasive breast cancer. Despite their better prognosis, the DCIS-group had comparable perceptions of the risk of recurrence and dying of breast cancer as women with invasive breast cancer. However, this did not appear to affect their well-being significantly.

We investigated self-reported health care utilisation of women who survived breast cancer for 10 years and identified predictors of health care utilisation.The population-based Eindhoven Cancer Registry was used to select all women who were diagnosed with breast cancer in 1993, in six hospitals in the Netherlands, and were disease-free at the time of data collection. Health status, psychological well-being, satisfaction with life and health care use were compared with same age controls. Logistic regression was used to identify predictors of health care utilisation.Of the 254 women who were sent a questionnaire, 183 (72%) responded. Breast cancer survivors had a similar health status and psychological well-being and a better satisfaction with life compared to same age controls. The proportion of breast cancer survivors (79%) who visited a specialist in the past 12 months was significantly higher compared to controls (53%). Young breast cancer survivors (45-54 at time of completing questionnaire) more often visited a physical therapist (56%) or complementary caregiver (26%) than controls (29 and 13%, respectively). Spontaneously reported problems (fatigue, arm problems) as a consequence of cancer and co-morbidity showed the strongest associations with health care utilisation.Although self-reported health, satisfaction with life and psychological well-being were similar or even better in long-term breast cancer survivors compared to those in population controls, survivors more often attended a specialist, physical therapist and complementary caregiver in the past 12 months. Survivors of young age appear to have the highest use of health care services compared to age-matched controls, especially related to fatigue and arm problems.

Background: This review focuses on the application of technologically advanced methods of audiovisual distraction as adjunct analgesic techniques; more specifically, (a) virtual reality (VR) and (b) audiovisual (A/V) eyeglass systems (A/V distraction).Purpose: It is assumed that distraction taxes the patient’s limited attention capacity, resulting in the withdrawal of attention from the noxious stimulus with a subsequent reduction in pain.Methods: Twenty studies evaluating the analgesic potential of both methods in different patient groups and in healthy volunteers were identified in the scientific literature.Results: Although the majority of these studies are hampered by serious methodological drawbacks, particularly a small number of participants, the results nevertheless strongly suggest that both VR and A/V distraction can be a very promising analgesic technique that may be used safely and effectively for the reduction of pain and discomfort during medical procedures. An additional important aspect is that few negative side effects have been reported.Conclusions: Directions for future research are presented.

Item does not contain fulltext BACKGROUND: The aim of this study was to examine the associations between urinary levels of the stress hormones adrenaline, noradrenaline and cortisol during treatment with self reported stress, in order to investigate the mechanism for the previously observed negative association of anxiety and depression with the outcome of IVF/ICSI. METHODS: In a multicentre prospective cohort study, women entering their first cycle of IVF/ICSI treatment were asked to participate. From each participant nocturnal urine samples were collected; pre-treatment, before oocyte retrieval and before embryo-transfer (ET), to assess hormonal concentrations. Additionally, two questionnaires were administered before the start of the treatment to measure anxiety and depression. RESULTS: 168 women completed the questionnaires and collected at least two urine specimens. A significant positive correlation between urinary adrenaline concentrations at baseline and ET and the scores on depression at baseline were found. In women with successful treatment, lower concentrations of adrenaline at oocyte retrieval and lower concentrations of adrenaline and noradrenaline at ET, compared with unsuccessful women, were found. CONCLUSIONS: The significant positive association of adrenaline concentration with pregnancy and with depression suggested that this adrenal hormone could be one of the links in the complex relationship between psychosocial stress and outcome after IVF/ICSI.

Background The aim was to explore measurements of arm circumference and shoulder abduction as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Methods Differences in arm circumference and shoulder abduction were measured in 465 consecutive women who underwent axillary lymph node dissection. These women received a treatment-specific questionnaire on the severity of physical disability and the effects on their daily life and well-being. Results The questionnaire was returned by 400 women (86 per cent). Of these 400, only the 332 women who did not receive axillary radiotherapy were included in the analysis. Their mean time since axillary lymph node dissection was 4·2 (range 0·3–28) years. For 86 patients (26 per cent) there was a difference in arm circumference of 2 cm or more, or a difference in abduction of 20° or more. These patients found it more difficult to do household chores, were more likely to have given up hobbies, felt more disabled and were more likely to be treated by a physiotherapist. However, complaints also occurred among the women with smaller differences in arm circumference and shoulder abduction, although the frequency and severity of their complaints were similar to those in women without swelling of the arm or without restricted shoulder abduction. Conclusion Measuring arm circumference and shoulder abduction during control visits identifies only some of the women whose daily life and well-being is affected by the side-effects of axillary lymph node dissection.

Objective:This study examined the effectiveness of hospital-based Video Interaction Guidance (VIG; Eliëns, 2010; Kennedy, Landor, & Todd, 2011) for mothers and fathers of infants born preterm (25-37 weeks of gestation).Method:VIG is a preventive video-feedback intervention to support the parent-infant relationship. One hundred fifty families (150 infants, 150 mothers, 144 fathers) participated in a pragmatic randomized controlled trial to evaluate the effects of VIG as adjunct to standard hospital care. Primary outcome was parental interactive behavior (sensitivity, intrusiveness, and withdrawal) as observed in videotaped dyadic parent-infant interaction. Secondary outcomes comprised parental bonding, stress responses, and psychological well-being based on self-report. The intervention effects were assessed at baseline, mid-intervention, 3-week, 3-month, and 6-month follow-ups. Data were analyzed on an intention-to-treat basis, using multilevel modeling and analyses of covariance.Results:VIG proved to be effective in enhancing sensitive behavior and diminishing withdrawn behavior in mothers (Cohen's d range = .24-.44) and in fathers (d range: .54-.60). The positive effects of VIG were particularly found in mothers who experienced the preterm birth as very traumatic (d range = .80-1.04). The intervention, however, did not change parents' intrusive behavior. Analyses additionally revealed positive effects on parental bonding, especially for fathers, yet no significant effects on stress and well-being were detected.Conclusions:The results indicate that VIG is a useful addition to standard hospital care, reducing the possible negative impact of preterm birth on the parent-infant relationship. VIG appeared particularly beneficial for fathers, and for mothers with traumatic birth experiences. High levels of parental intrusiveness, however, need complementary intervention

This prospective study examined whether or not a mother’s representations of her infant were more often disrupted after premature childbirth. Furthermore, the study examined if different components of maternal interactive behavior mediated the relation between maternal disrupted representations and infant attachment. The participants were mothers of full-term (n = 75), moderately preterm (n = 68) and very preterm infants (n = 67). Maternal representations were assessed by the Working Model of the Child Interview at 6 months post-partum. Maternal interactive behavior was evaluated at 6 and 24 months post-partum, using the National Institute of Child Health and Human Development Early Care Research Network mother–infant observation scales. Infant attachment was observed at 24 months post-partum and was coded by the Attachment Q-Set. The results reveal that a premature childbirth does not necessarily generate disrupted maternal representations of the infant. Furthermore, maternal interactive behavior appears to be an important mechanism through which maternal representations influence the development of infant attachment in full-term and preterm infants. Early assessment of maternal representations can identify mother–infant dyads at risk, in full-term and preterm samples.Keywords: Preterm birth, Maternal disrupted representations, Maternal interactive behavior, Infant attachment

Aim: To explore the prevalence, phenomenology, and background of leisure sickness, i.e., the condition of people developing symptoms of sickness during weekends and/or vacations. Method: In order to obtain an estimate of its prevalence, a representative Dutch sample consisting of 1,128 men and 765 women was asked to indicate to what extent they recognized themselves in our description of weekend and vacation sickness. For the investigation of the phenomenology and background of this condition and the characteristics of the patients suffering from it, questionnaire data were collected in new samples consisting of 114 cases and 56 controls. Questions referred to symptoms, onset, duration, appreciation of weekend and vacation activities, and appraisal of work and workload. Results: In the case of male respondents, 3.6 and 3.2% recognized themselves in the description of the weekend and the vacation syndrome, respectively, compared with 2.7 and 3.2% women. Most frequently reported symptoms were headache/migraine, fatigue, muscular pains, and nausea. In addition, viral infections (flue-like, common cold) were often reported in relation to vacations. Cases had generally suffered from leisure sickness for over 10 years and the onset was associated with stressful conditions. They attributed their condition to difficulties with the transition from work to nonwork, stress associated with travel and vacation, as well as workload and personality characteristics. There were no significant group differences in the appreciation of weekend and leisure activities or lifestyle during days off. Most striking differences were found with respect to experienced workload, sense of responsibility, and inability to relax. Conclusion: Leisure sickness is a relatively common condition. Specific lifestyle factors or leisure activities seem to be less relevant for its development. Concerning risk factors, the data tend to point to high workload and person characteristics, namely, the inability to adapt to the nonworking situation, a high need for achievement, and a high sense of responsibility with respect to work. Future studies should be designed for testing specific hypotheses concerning the underlying mechanisms and evaluating the effectiveness of psychological and/or physical activity interventions.

Repeatedly, hypertensives have been found to appraise physical stressors as less aversive than normotensives. The main aim of the present study was to examine the effects of gender and cardiovascular reactivity in the relationship between hypertension and appraisal of pain. Forty-two unmedicated hypertensives and 21 normotensive controls of both genders were exposed to an electric current stimulus, while various cardiovascular parameters and pre-stressor anxiety were measured. In general, hypertensive women, but not men, showed diminished pain sensitivity compared to their normotensive counterparts. When the analyses were repeated with controlling for cardiovascular reactivity, the between-group effects were no longer significant. The results indicate that (i) profound gender differences exist in hypertension-related pain sensitivity and (ii) these effects seem to be mediated, at least partly, by cardiovascular reactivity.

This paper reviews psychological research within the context of in vitro fertilization (IVF). The focus will be on psychological reactions before entering an IVF-procedure, during an IVF-treatment, and after both unsuccessful and successful IVF. The effects of psychosocial factors on the treatment outcome after IVF and interventions on conception rates will also be discussed. Undergoing an IVF-treatment is an emotional and physical burden, for both the woman and her partner. Research results suggest that couples entering an IVF-treatment program are, in general, psychologically well adjusted. Concerning reactions during the treatment, both women and men experience waiting for the outcome of the IVF-treatment and an unsuccessful IVF. as most stressful. Common reactions during IVF are anxiety and depression, while after an unsuccessful IVF, feelings of sadness, depression and anger prevail. After a successful IVF-treatment, IVF-parents experience more stress during pregnancy than 'normal fertile' parents. Mothers with children conceived by IVF express a higher quality of parent child relationship than mothers with a naturally conceived child. Research further suggests that psychosocial factors, like ineffective coping strategies, anxiety and/or depression are associated with a lower pregnancy rate following IVF-procedures. In addition, support has been found suggesting that stress reduction through relaxation training or behavioral treatment improves conception rates.

Background: The aim of the study was to examine the proneness, the functions and triggering situations of weeping in anorexic and bulimic women. Methods: Participants were 36 anorexic and 31 bulimic female patients and 56 age-matched female controls. All women completed the Questionnaire on Adult Crying. We limited our study to results on ‘crying proneness’, ‘functions of crying’ and ‘determining factors of crying’. Results: Bulimic patients reported to have cried significantly more often in the last 4 weeks, to be more likely to cry in situations of distress and to have used weeping significantly more often as a manipulative behavior than control women. Anorexic patients rated their tendency to cry significantly lower and experienced weeping as significantly more negative than controls. Conclusions: Compared to control women, anorexic patients associated weeping with negative feelings as opposed to bulimic patients who appeared to use weeping on an intentional basis. These deviations from control women seem to mirror the introvert character of anorexic patients and the extrovert impulsive personality of patients with bulimia nervosa, respectively.

To obtain a better understanding of the inhibited emotional expression often reported in breast cancer patients, the authors compared 48 breast cancer patients and 49 healthy women with respect to disturbed emotional processes (alexithymia), emotional disclosure, emotional expression, assertiveness, repression, and distress. The patient group showed significantly more ambivalence over emotional expression, more restraint, and more anxiety than the healthy controls. No differences were found between the 2 groups in alexithymia, expressing emotions in general, or willingness to talk with others about emotions. The image of the breast cancer patient that emerged in the study was that of a person who has conflicting feelings with regard to expressing emotions, is reserved and anxious, is self-effacing, and represses aggression and impulsiveness. These findings suggest that cancer patients' inhibited behavior is a reaction to the disease rather than a reflection of a personality characteristic predisposing an individual to (breast) cancer.

Background: This article describes the construction and validation of the Amsterdam Alexithymia Scale (AAS) and explores some of the nomological net of alexithymia. Methods: Four correlational studies are presented. The internal structure of the AAS is explored by factor analyses on items. Correlations of the AAS with sex and (Guilford) intellectual abilities are established. Mean scores of three different professional groups are compared. Correlations between the AAS and several clinical and personality scales are determined. Students served as subjects in all studies (347Results: The 20-item AAS has a stable 5-factor structure, covering 5 defining features of alexithymia: difficulties in, respectively, experiencing emotions, fantasizing, analyzing emotions, differentiating between emotions and verbalizing emotions. The AAS showed to be reliable. The AAS scores were independent of verbal and nonverbal IQ. As expected, the AAS scores turned out to be significantly lower in a group of dramatic art students and significantly higher in a group of math and artificial intelligence students, when compared to psychology students. The AAS scores correlated negatively with extroversion, positively with social inadequacy and not with neuroticism. Finally, correlations between the AAS and the Adjective Check List scores indicated that alexithymia is associated with, respectively, a neglect of own needs and impulses, a reduced capability to understand social situations and a tendency to stick to rules rigidly, to flee into social isolation, to be submissive, to avoid commitment and to experiences of lack of personal meaning in life. Conclusion: The AAS is the first instrument measuring the 5 defining features of alexithymia reliably and validly.

Objective To examine the predictive value of parent, infant, and contextual factors related to preterm childbirth for later parenting behaviors. Methods Mothers (n = 217) and fathers (n = 204) of term, moderately preterm, and very preterm infants were interviewed 1 month postpartum using the Clinical Interview for Parents of high-risk infants (CLIP), to assess their experiences and perceptions related to the pregnancy, delivery, infant, hospitalization, support system, and their narratives. Their responses were factor analyzed and entered into prediction models of parental behaviors (National Institute of Child Health and Human Development observations) 6 months postpartum. Results Preterm birth was associated with negative experiences and concerns in parents. Regression analyses revealed, however, that irrespective of preterm birth, negative and unrealistic parental perceptions predicted less sensitive, more intrusive, and more withdrawn behavior. Conclusions Not prematurity per se, but particularly the presence of negative perceptions in parents, is predictive of difficulties in parent–infant interaction. The CLIP is a potentially useful instrument to identify families at risk.Keywords: CLIP interview, parent–infant interaction, parental perceptions, postpartum experiences, prematurity.Topic:father infant, premature labor perception postpartum period parenting behavior social support contextual factors premature birth parental perception narrative discourse