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Objective: The impact of two types of oncologists' emotion-oriented communication on participants' recall of medical information was investigated, and the potential mediation by a reduction in emotional stress. Additionally, moderation effects by personal characteristics were explored., Methods: An oncologist's communication in response to a patient's emotional expressions was manipulated during a videotaped, scripted bad-news consultation. Three conditions were created: 1) standard communication, 2) emotion-oriented silence, and 3) emotion-oriented speech. Participants (N = 217) were randomly allocated to one of the three conditions. Measurements included information recall (free recall and recognition), emotional stress (self-reported and physiological), and personal characteristics., Results: Emotion-oriented silence (p = .002) and speech (p = .019) enhanced information recognition compared to standard communication. No differences in free recall were found. Emotional stress did not mediate these relations. Poorer functional health literacy predicted poorer recognition, but this was counteracted by emotion-oriented communication., Conclusions: By means of acknowledging, exploring, empathic and supportive statements, and attentive silence, the oncologist's communication resulted in better information recognition. How oncologists' communication impacts patients' information recall warrants further investigation, as this could not be explained by reducing emotional stress., Practice Implications: These insights will help educators to validate the relevance of emotion-oriented strategies, and encourage oncologists to adopt them., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: Early relational trauma has been posited to be responsible for dysfunctional self schema as negative feedback derived from abusive close others may influence the development of self-evaluation. However, the association between early relational trauma and negative self-evaluation has proven inconsistent. In addition to the evaluative aspect, early relational trauma may impact on the procedural aspect of self schema, with a difficulty in differentiating mental representations derived from others from those generated internally by the self., Method: To test this hypothesis, the authors adopted a source attribution paradigm tapping on the distinction between mental representations generated by the self or derived from another person in a nonclinical sample, together with scales measuring self-evaluation and early relational experiences., Results: The results showed that individuals with early relational trauma tended to attribute the representations externally derived as internally generated, although there were no associations between early relational trauma and self-evaluation. Importantly, early relational trauma had unique contribution to source misattribution independent from common covariates including early nonrelational trauma, parental dysfunction, general memory function, and negative affect states., Conclusions: Erroneously identifying information derived from other people as self-generated may be a specific sociocognitive propensity linked to early relational trauma and may impact upon the development of self schema. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Objective: The aim of this paper is to discuss experimental research investigating the effect of physicians' affect-oriented communication on patients' recall of information provided during medical consultations, with a special focus on the mediating role of emotional stress in that relation., Methods & Results: A search of experimental research literature was conducted, resulting in six research articles experimentally investigating the relations of interest, all using a video-vignettes design. A summary of results is provided and discussed., Conclusions: The research reviewed in this paper provides evidence for the causal and mostly positive influence of several forms of affect-oriented communication on patients' recall of medical information. Results indicate that reducing emotional stress may not be the underlying mechanism through which physicians' communication influences patients' recall., Practice Implications: The obtained insights will help educators to teach evidence-based medical communication skills and to scientifically validate the importance of these skills for patients' recall of information. Advancing physicians' communication skills with evidence-based training will contribute to the professionalism that is the hallmark of good quality of care., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Patients forget 20-80% of information provided during medical consultations. The emotional stress often experienced by patients during consultations could be one of the mechanisms that lead to limited recall. The current experimental study therefore investigated the associations between (analog) patients' psychophysiological arousal, self-reported emotional stress and their (long term) memory of information provided by the physician. One hundred and eighty one cancer-naïve individuals acted as so-called analog patients (APs), i.e. they were instructed to watch a scripted video-recoding of an oncological bad news consultation while imagining themselves being in the patient's situation. Electrodermal and cardiovascular activity (e.g. skin conductance level and heart rate) were recorded during watching. Self-reported emotional stress was assessed before and after watching, using the STAI-State and seven Visual Analog Scales. Memory, both free recall and recognition, was assessed after 24-28 h. Watching the consultation evoked significant psychophysiological and self-reported stress responses. However, investigating the associations between 24 psychophysiological arousal measures, eight self-reported stress measures and free recall and recognition of information resulted in one significant, small (partial) correlation (r = 0.19). Considering multiple testing, this significant result was probably due to chance. Alternative analytical methods yielded identical results, strengthening our conclusion that no evidence was found for relationships between variables of interest. These null-findings are highly relevant, as they may be considered to refute the long-standing, but yet untested assumption that a relationship between stress and memory exists within this context. Moreover, these findings suggest that lowering patients' stress levels during the consultation would probably not be sufficient to raise memory of information to an optimal level. Alternative explanations for these findings are discussed.

Background: Prolonged cardiac activity that exceeds metabolic needs can be detrimental for somatic health. Psychological stress could result in such "additional cardiac activity.", Purpose: In this study, we examined whether prolonged additional reductions in heart rate variability (AddHRVr) can be measured in daily life with an algorithm that filters out changes in HRV that are purely due to metabolic demand, as indexed by movement, using a brief calibration procedure. We tested whether these AddHRVr periods were related to worry, stress, and negative emotions., Methods: Movement and the root of the mean square of successive differences (RMSSD) in heart rate were measured during a calibration phase and the subsequent 24 h in 32 participants. Worry, stress, explicit and implicit emotions were assessed hourly using smartphones. The Levels of Emotional Awareness Scale and resting HRV were used to account for individual differences. During calibration, person-specific relations between movement and RMSSD were determined. The 24-h data were used to detect prolonged periods (i.e., 7.5 min) of AddHRVr., Results: AddHRVr periods were associated with worrying, with decreased explicit positive affect, and with increased tension, but not with the frequency of stressful events or implicit emotions. Only in people high in emotional awareness and high in resting HRV did changes in AddHRVr covary with changes in explicit emotions., Conclusions: The algorithm can be used to capture prolonged reductions in HRV that are not due to metabolic needs. This enables the real-time assessment of episodes of potentially detrimental cardiac activity and its psychological determinants in daily life., Competing Interests: Compliance with Ethical Standards Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards Authors Bart Verkuil, Jos F. Brosschot, Marieke S. Tollenaar, Richard D. Lane, and Julian F. Thayer declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible institutional committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Several studies have shown that stress and glucocorticoids can impair prefrontal-dependent working memory (WM) performance. WM is the ability to attend to the task at hand, and to maintain relevant information in mind during a delay while ignoring irrelevant stimuli. Here, it is investigated whether stress hormones impair WM by reducing the ability to suppress distracting, irrelevant neutral and emotional stimuli. Hydrocortisone (35 mg) (n=23) or placebo (n=21) was administered to young, healthy men, who performed a Sternberg WM task with neutral and emotional irrelevant distracters shown in the delay-phase of the task, between encoding and recognition of the relevant stimuli for WM. Contrary to expectations, enhanced WM performance with higher processing speed and a reduction of errors was found in the hydrocortisone group compared to placebo. Moreover, hydrocortisone significantly reduced the distraction by emotional stimuli. These findings show that cortisol effects on WM are not unambiguous and contrast with previous findings on the impairing effects of cortisol on WM. Dose-response studies could give more insight into the specific modulating effects of glucocorticoids on suppression of irrelevant emotional distraction.

Autobiographical memories have been found to be less specific after hydrocortisone administration in healthy men, resembling memory deficits in, for example, depression. This is the first study to investigate the effects of stress-induced elevated cortisol levels on autobiographic memory specificity and experience in healthy young men. Autobiographical memories were elicited by neutral and negative cue words, with instructions to recall either recent or remote memories. No effect of psychosocial stress was found on memory specificity or experience, but cortisol increases tended to be related to less specific, recent memories elicited by neutral cue words, especially when participants were physically aroused during memory retrieval. These results indicate that autobiographical memories are fairly resistant to an acute stressor in healthy young men, but that endogenous cortisol increases might be related to autobiographical memory retrieval. More research into the relation between endogenous cortisol increases and autobiographic memory retrieval is needed, especially in stress-related disorders.

Previous studies have found impairing effects of stress hormones on memory retrieval. So far, it is unknown whether these impairments are temporary, persistent throughout time, or whether the strength of the memory trace changes after retrieval because of the effects of stress hormones on memory processes during retrieval. In the present study, delayed cued recall (6 months after initial learning) was compared between male participants who had retrieved previously learned word pairs during stress or a control condition. Retrieval (with or without stress) had taken place either 1 day or 5 weeks after initial encoding. The group that had retrieved words under stress 5 weeks after encoding performed worse on long-term recall than the comparable control group. However, when words were retrieved under stress 1 day after encoding, no long-term effect was found, although performance at 6 months in relation to performance under stress was slightly increased compared to the control group. These results support previous findings in animals that stress may affect memory during reactivation. It further suggests that time intervals between encoding and reactivation may play an important role., ((Copyright) 2008 APA, all rights reserved.)

In this study the effects of stress-induced cortisol increases on long-term memory retrieval during and after acute psychosocial stress were examined. Seventy male students were exposed to either a psychosocial stress task or to a non-stressful control task. During and after this task, retrieval was tested for idiosyncratic emotionally negative and neutral word pair associations that were learned 1 day or 5 weeks earlier. Within the stress condition, retrieval of negative words, 5 weeks after learning, was impaired both during and after the stress task compared to the control group. Further, during the stress task, when sympathetic activity was enhanced, impaired retrieval of both neutral and emotional words was significantly related to enhanced cortisol response. In contrast, after the stress task, when cortisol levels were still increased but sympathetic activity was low again, no association was found between cortisol increase and retrieval of either neutral or emotional material. These results are in line with the previous animal research showing that when arousal is high, cortisol increase can impair memory retrieval.

Background: Animal and human studies have found that prior stressful events can result in an altered reactivity in the HPA axis. The aim of the present study was to investigate the role of adverse events in childhood on cortisol reactivity to psychosocial stress in young healthy subjects (n=80)., Methods: Salivary cortisol levels were measured before, during and after exposure to a psychosocial stress task in healthy men and women with high (n=33) and low (n=47) exposure to adverse childhood events., Results: A significant blunted cortisol response was found in individuals with a history of adverse events compared to individuals with no adverse life events, with no differences in baseline cortisol levels. This finding appeared to be primarily driven by men. The groups did not differ on any other physiological or subjective stress measure, including heart rate, blood pressure, and subjective tension., Conclusions: These findings suggest that, at least in healthy young males, adverse childhood events are associated with changes in HPA-axis functioning. Longitudinal studies are needed to investigate whether the blunted cortisol response is a risk factor in the etiology of psychiatric disorders or rather reflects resiliency with regard to the development of psychopathology.