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Objective: Various psychosocial interventions have been developed to reduce distress and improve quality of life (QoL) in patients with advanced cancer, many of which are traditional cognitive‐behavioral interventions (CBIs) or mindfulness‐based interventions (MBIs). The aims of this meta‐analysis were to determine and compare the overall effects of traditional CBIs and MBIs on distress and QoL in this population and to explore potential moderators of intervention efficacy. Methods: A systematic search was conducted in CINAHL, Embase, PsycINFO, PubMed, and Web of Science. Randomized controlled trials (RCTs) comparing CBIs or MBIs to controls on distress and QoL outcomes were eligible for inclusion. Random effects meta‐analyses using standardized baseline to post‐intervention mean differences were calculated using Hedges's g. Meta‐regressions were used to compare intervention effects and examine potential moderators. Results: Across 37 RCTs (21 CBIs, 14 MBIs, 2 combination therapies), there was a small decrease in distress (Hedges's g = 0.21) and a minimal improvement in QoL (Hedges's g = 0.15). Traditional CBIs and MBIs did not differ in effect sizes. Heterogeneity was significant across distress effect sizes but not across QoL effects. Interventions delivered to individuals (vs. dyads/group) had larger effects on QoL. No moderators of intervention effects on distress were found. Conclusions: Findings suggest traditional CBIs and MBIs produce small reductions in distress compared to controls in patients with advanced cancer, although effects on QoL appear minimal. Given limitations in the number of studies and their quality, rigorous trials are needed to directly compare the impact of traditional CBIs and MBIs in this population. [ABSTRACT FROM AUTHOR]

Objective: A brief, valid, and comprehensive measure of mindfulness is needed for cancer populations. This study examined the factor structure, internal consistency, construct validity, and measurement invariance of the 10‐item Cognitive Affective Mindfulness Scale‐Revised (CAMS‐R) in patients with cancer. Methods: Patients with breast, gastrointestinal, lung, or prostate cancer (N = 404, 50% stage IV cancer, 51% women) were recruited from academic and public clinics in Indianapolis, IN. Patients completed the CAMS‐R and other psychological measures at one time point. Confirmatory factor analysis (CFA) was used to examine the dimensionality of the CAMS‐R. Internal consistency and construct validity were also assessed. Measurement invariance was examined for gender, cancer type, and cancer stage. Results: CFA showed that the original CAMS‐R structure with four first‐order factors (attention, present focus, awareness, and acceptance) and one second‐order factor (mindfulness) had a reasonable fit (RMSEA = 0.09, CFI = 0.95, SRMR = 0.04). Internal consistency was excellent (α = 0.90). The CAMS‐R total score showed significant positive associations with several subscales of a widely used mindfulness questionnaire and self‐compassion (rs = 0.61–0.66) and significant negative associations with anxiety, depressive symptoms, rumination, psychological inflexibility, and avoidant coping (rs = −0.35–0.58). Measurement invariance testing indicated that the CAMS‐R was invariant across populations of varying genders, cancer types, and stages. Conclusions: Findings provide preliminary support for using the CAMS‐R in cancer populations. Future research should assess the responsiveness of the CAMS‐R to intervention. [ABSTRACT FROM AUTHOR]

Cancer patients have high rates of persistent and disabling symptoms. Evidence suggests that social constraints (e.g., avoidance and criticism) negatively impact symptoms, but pathways linking these variables have yet to be identified. This study examined whether cancer-related loneliness (i.e., feeling socially disconnected related to having cancer) mediated the relationships between social constraints and symptoms (i.e., pain interference, fatigue, sleep disturbance, and cognitive complaints) in patients with various cancers (N = 182). Patients (51% female, mean age = 59) were recruited from the Indiana Cancer Registry and completed questionnaires assessing social constraints, cancer-related loneliness, and symptoms. Structural equation modeling was used to evaluate the hypothesized relationships among variables. The model demonstrated good fit. Consistent with our hypothesis, cancer-related loneliness mediated the relationships between social constraints and each symptom. Findings suggest that addressing cancer-related loneliness in symptom management interventions may mitigate the negative impact of social constraints on outcomes., Author(s): Rebecca N. Adams [sup.1] , Catherine E. Mosher [sup.2] , Joseph G. Winger [sup.3] , Rafat Abonour [sup.4] , Kurt Kroenke [sup.4] [sup.5] [sup.6] Author Affiliations: (Aff1) 0000000419368956, grid.168010.e, [...]

Although cognitions have predicted young adults' human papillomavirus (HPV) vaccine decision-making, emotion-based theories of healthcare decision-making suggest that anticipatory emotions may be more predictive. This study examined whether anticipated regret was associated with young adults' intentions to receive the HPV vaccine above and beyond the effects of commonly studied cognitions. Unvaccinated undergraduates (N = 233) completed a survey assessing Health Belief Model (HBM) variables (i.e., perceived severity of HPV-related diseases, perceived risk of developing these diseases, and perceived benefits of HPV vaccination), anticipatory emotions (i.e., anticipated regret if one were unvaccinated and later developed genital warts or HPV-related cancer), and HPV vaccine intentions. Anticipated regret was associated with HPV vaccine intentions above and beyond the effects of HBM variables among men. Among women, neither anticipated regret nor HBM variables showed consistent associations with HPV vaccine intentions. Findings suggest that anticipatory emotions should be considered when designing interventions to increase HPV vaccination among college men., Author(s): Shannon M. Christy[sup.1] [sup.2] , Joseph G. Winger[sup.2] , Elizabeth W. Raffanello[sup.3] , Leslie F. Halpern[sup.3] , Sharon Danoff-Burg[sup.4] , Catherine E. Mosher[sup.2] Author Affiliations: (1) Health Outcomes and [...]

Objective: A strong therapeutic alliance has been found to predict psychotherapeutic treatment success across a variety of therapeutic modalities and patient populations. However, only a few studies have examined therapeutic alliance as a predictor of psychotherapy outcome among cancer survivors, and none have examined this relation in telephone-administered cognitive-behavioral therapy (T-CBT). This study evaluated the extent to which therapeutic alliance affected psychotherapy outcomes in survivors of hematopoietic stem cell transplantation (HSCT), a treatment for some cancers. Method: Forty-six patients enrolled in a randomized clinical trial of T-CBT for posttraumatic stress disorder (PTSD) completed a baseline assessment (including self-report measures of PTSD symptoms, depression, and general distress), 10 individual T-CBT sessions, and follow-up assessments at 6, 9, and 12 months post-baseline. Therapeutic alliance was assessed after the 3rd T-CBT session with the Working Alliance Inventory, which yields overall and subscale (task, bond, and goal) scores. Results: Analyses revealed that higher total therapeutic alliance scores prospectively predicted decreased depressive symptomatology; higher task scores predicted decreased overall distress, depressive symptomatology, symptoms of re-experiencing, and avoidance; and higher bond scores predicted decreased depressive symptomatology and symptoms of re-experiencing. Conclusions: These results suggest that assessments of therapeutic alliance should be incorporated into routine clinical care, and therapeutic alliance should be specifically cultivated in interventions to maximize psychotherapeutic benefits involving vulnerable populations such as cancer survivors. (Contains 4 tables.)

Objective: Hematopoietic stem cell transplant (HSCT) survivors who are 1 to 3 years posttransplant are challenged by the need to resume valued social roles and activities--a task that may be complicated by enduring transplant-related psychological distress common in this patient population. The present study investigated whether transplant survivors who receive adequate social support from their spouse or intimate partner experience lower distress. Method: Effects of receiving a greater quantity of partner support (a common approach to studying enacted support) were compared with effects of receiving more effective partner support (i.e., support that more closely matches their needs in terms of its quantity and quality). Men and women (N = 230) who were 1 to 3 years posttransplant completed measures of partner support quantity (Manne & Schnoll, 2001), partner social support effectiveness (Rini & Dunkel Schetter, 2010), and psychological distress (Brief Symptom Inventory; Derogatis & Spencer, 1982). Potential medical and sociodemographic confounds were controlled in analyses. Results: As hypothesized, survivors reported less distress when they received more effective partner support (p less than 0.001). Quantity of partner support was not associated with distress (p = 0.23). An interaction revealed that when partner support was effective, the quantity of support survivors received was not associated with their distress (p = 0.90); however, when partner support was ineffective, receiving a greater quantity of partner support was associated with substantially elevated distress (p = 0.002). Conclusions: Findings suggest that clinical approaches to addressing or preventing enduring distress after HSCT should target features of partner support related to its appraised effectiveness. (Contains 3 tables and 1 figure.)

Our study tested an extension of the social resource model in an urban sample of 129 African American and 114 European American adolescents. Maternal involvement was positively related to the use of active and avoidant coping strategies among youth of both ethnicities. Additionally, use of active coping strategies was related to greater coping efficacy, which, in turn, was associated with less depressive symptomatology. For African Americans, avoidant coping was related to greater coping efficacy, which, in turn, was associated with less depressive symptoms. For European Americans, avoidant coping was not significantly related to coping efficacy. Our findings underscore the importance of examining developmental models across ethnic/racial groups and suggest that adolescent mental health programs may benefit from culturally sensitive attention to coping beliefs and practices.

In a study designed to examine correlates of cancer-related stigma, 405 college students were assigned randomly to listen to an audiotaped interview in which the target's cancer type and smoking status were manipulated. In the lung cancer conditions, target gender also was manipulated. Social distance and emotional responses differed according to participant gender, death anxiety, and target cancer type. Participant gender and target characteristics also were associated with perceptions of the target's character. Findings partially support terror management theory and suggest that death attitudes, gender norms, and diagnostic status influence social distancing from individuals with cancer. (Contains 3 tables.)

This investigation examines mechanisms through which optimism may influence psychological adjustment among 133 Black college students. Specifically, this study evaluates the extent to which active and avoidant coping and social support account for the association between optimism and depressive symptoms. Participants completed questionnaires that included the Life Orientation Test--Revised, the COPE, the Social Provisions Scale, and the 12-item Center for Epidemiological Studies Depression Scale. Avoidant coping and social support mediated the relation between optimism and depressive symptoms, whereas active coping did not mediate this relationship. Results partially replicate those of prior research and illustrate the need for culturally sensitive theory regarding the combined effect of personality, coping strategies, and social support on psychological adjustment to stressful situations. (Contains 1 figure and 3 tables.)

The purpose of this study was to examine three competing models of the relations among perceived discrimination, social support, and indicators of psychological adjustment in a sample of 135 African American college students. The three competing models, social support buffering, social support mobilization, and social support deterioration, were tested within a regression framework. The buffering model, which predicted that social support would interact with perceived discrimination such that individuals with high levels of social support would be protected from the harmful effects of discrimination, was not supported. The social support mobilization model, which predicted that support networks would mobilize to support individuals exposed to discrimination, was also not supported. Support was only obtained for the social support deterioration model, which predicted that social support would decrease for those exposed to discrimination. Perceived racial discrimination was associated with lower perceptions of social support, greater symptoms of depression, and lower levels of life satisfaction. (Contains 1 figure and 2 tables.)

Social constraints on cancer-related disclosure have been associated with increased distress among cancer patients. The goals of this meta-analysis were: (1) to quantify the average strength of the relationships between social constraints and general and cancer-specific distress in cancer patients; and (2) to examine potential moderators of these relationships. A literature search was conducted using electronic databases, and 30 studies met inclusion criteria. Moderate, significant relationships were found between social constraints and both general distress (r = 0.37, 95 % CI 0.31-0.43) and cancer-specific distress (r = 0.37, 95 % CI 0.31-0.44). The relationship between social constraints and cancer-specific distress was stronger for studies of patients who, on average, had been diagnosed more recently. Relationships between social constraints and both general and cancer-specific distress did not vary by age or gender. Findings suggest that social constraints may be important to target in interventions to reduce distress in cancer patients, especially those who have been recently diagnosed. Electronic supplementary material The online version of this article (doi:10.1007/s10865-014-9601-6) contains supplementary material, which is available to authorized users., Author(s): Rebecca N. Adams[sup.1] , Joseph G. Winger[sup.1] , Catherine E. Mosher[sup.1] Author Affiliations: (1) Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, 46202, Indianapolis, [...]