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ObjectiveHow couples communicate about cancer is an important predictor of psychological outcomes for men diagnosed with localised prostate cancer and their spouses. We examined the predictive role of disclosure, responsiveness, mutual avoidance, and holding back on depressive symptoms, psychological adjustment, cancer-specific distress, and cancer concerns.MethodsEighty-one prostate cancer patients and their spouses completed measures of communication at baseline and measures of four psychological outcomes at baseline, five, 12, and 26 weeks after baseline. Dyadic growth models tested the effects of time and role on each outcome over time.ResultsHigher disclosure and responsiveness predicted better psychological outcomes. Less mutual avoidance and holding back predicted poorer psychological outcomes. Across communication variables, individuals who engaged in poorer communication initially had poorer psychological outcomes that improved over time, whereas individuals who engaged in better communication initially maintained their more positive standing without change or changed in the positive direction. For all outcomes, those with better communication still had better psychological outcomes at six months.ConclusionCouples' cancer-specific relationship communication predicts their psychological outcomes. More research is needed to identify effective interventions, including a longer therapy course, individual communication training, or greater focus on addressing barriers to sharing and responsiveness.

ObjectivesFew couple-focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy-enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators.DesignThis study was a randomized clinical trial with three study arms and four assessment time points.MethodsA total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post-baseline. Primary outcomes were psychological adjustment, depression, cancer-specific distress, cancer concerns, and relationship satisfaction.ResultsSpouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5-week follow-up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW.ConclusionsIntimacy-enhancing therapy did not show an impact on general or cancer-specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple-focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health-related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples' psychological adaptation to prostate cancer. Couple-focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple-focused interventions. What does this study add? Intimacy-enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy-enhancing therapy was superior to no treatment for patients in longer-term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.

The present study focused on intimacy processes in the relationships of men diagnosed with localized prostate cancer and their partners. Using the actor-partner interdependence model (APIM), we examined the interpersonal process model of intimacy, which proposes associations between self- and perceived partner disclosure about cancer and perceived partner responsiveness as predictors of global relationship intimacy. The study's outcomes were patients' and spouses' ratings of global relationship intimacy. Both actor (my disclosure predicts my intimacy) and partner (my partner's disclosure predicts my intimacy) effects were examined, as well as possible moderating effects for cancer-related concerns. Two hundred and nine couples in which one or both partners reported elevated cancer-specific distress completed measures of self- and perceived partner disclosure and perceived partner responsiveness regarding discussions about prostate cancer, global relational intimacy, and cancer-related concerns. Results were consistent with the interpersonal process model of intimacy in that perceived responsiveness mediated the association between self- and perceived partner disclosure about cancer and global relational intimacy for both patients and spouses. Results also indicated moderation of the links between disclosure and relational intimacy by level of patient cancer-related concerns such that the links were stronger when concerns were higher. Finally, there was also evidence of moderated mediation such that indirect effects of disclosure on relational intimacy via perceived partner responsiveness were stronger when concerns were higher. Interventions for distressed couples coping with prostate cancer would benefit from focusing on facilitating disclosure and responsiveness, particularly among distressed couples who report cancer concerns. (PsycINFO Database Record

The present study evaluated intimacy as a mechanism for the effects of holding back sharing concerns about cancer on couples' psychological distress, well-being, and marital satisfaction using the actor-partner interdependence model (APIM), and evaluated 2 possible moderators of these associations: the number of patient and spouse cancer concerns. We had 139 men treated for localized prostate cancer in the past year and their spouses complete surveys about holding back sharing cancer concerns, intimacy, distress, and relationship satisfaction, as well as patient and spouse cancer concerns. APIM-indicated that the association between holding back sharing concerns, and patient and spouse distress, well-being, and relationship satisfaction could be partially accounted for by their influence on patient and spouse perceptions of relationship intimacy. The number of cancer concerns did not moderate the mediational model. Holding back has strong associations with both partners' well-being and distress. Holding back sharing concerns was particularly detrimental for couples' intimacy and relationship satisfaction.

Introduction: Sustaining the well-being of the caregiving family is a critical agenda in cancer care. In the multidisciplinary team, nurses often serve as a bridge between the family and oncology [...]

Objective: Little attention has been paid to the role of nonspecific therapy processes in the efficacy of psychological interventions for individuals diagnosed with cancer. The goal of the current study was to examine the three constructs from the generic model of psychotherapy (GMP): therapeutic alliance, therapeutic realizations, and therapeutic openness/involvement in the treatment outcome of women with gynecological cancers attending either a 7-session supportive counseling intervention or a coping and communication skills intervention. Method: Two hundred and three women completed measures of alliance, realizations, and openness after Intervention Sessions 2, 3, and 6, as well as measures of depressive symptoms after these sessions and 6 months after the pre-intervention assessment (posttreatment). Results: Consistent with the GMP, in early sessions, therapeutic bond predicted openness in terms of positive affect experienced during sessions, and both aspects of openness (positive and negative affect), in turn, predicted more therapeutic realizations. Therapeutic realizations predicted perceptions of greater session progress, and greater therapeutic bond predicted more therapeutic realizations. When early session GMP variables were used to predict later GMP processes and outcomes and posttreatment outcomes, early therapeutic bond predicted later session therapeutic realizations directly and indirectly via emotional arousal, emotional arousal predicted session progress, session progress predicted lower postsession depressive symptoms, and depressive symptoms as rated after Session 6 predicted depressive symptoms 3 months posttreatment. However, a number of additional associations among GMP processes were found. Conclusions: Our results suggest that therapy processes played a role in predicting both short- and long-term treatment outcomes. (Contains 4 tables and 3 figures.)

Conducted a prospective longitudinal study to investigate whether anxiety, depressive, personality, or substance abuse disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Findings for 201 adolescents suggest that adolescents with chronic depressive symptoms may be at elevated risk for the development of BN or BED, and that those with eating disorders may be at elevated risk for the development of depressive disorders. (SLD)

Although adults with anxiety disorders often report interpersonal distress, the degree to which anxiety is linked to the quality of close relationships remains unclear. The authors examined the relational impact of anxiety by sampling the daily mood and relationship quality of 33 couples in which the wife was diagnosed with an anxiety disorder. Use of a daily process design improved on prior methodologies by capturing relational processes closer to their actual occurrence and in the setting of the diagnosed partner's anxiety. Analyses revealed significant associations between wives' daily anxiety and both partners' perceptions of relationship quality. Associations were moderated by anxiety-specific support. Results also indicated significant concordance between wives' daily anxiety and husbands' distress. Concordance was stronger for husbands who reported frequent accommodation of wives' anxiety symptoms. Findings are discussed in the context of existing evidence on the social costs of anxiety disorders. Keywords: anxiety disorders, couples, marriage, marital distress, relationship functioning DOI: 10.1037/a0018473

Distress reverberates throughout the family during palliative care and bereavement, inviting consideration of a family-centered model of care. Targeting families thought to be 'at risk' has merit. The Family Focused Grief Therapy model was tested in a randomized controlled trial of 81 families (353 individuals) and bereavement outcome is reported here for treatment completers compared to controls. There were no significant baseline differences between treatment completers and non-completers. Significant reduction in distress occurred at 13 months post death for the families completing treatment, with further improvements for the 10% of individuals most distressed at baseline. A preventive model of family-centered care applied to those at greatest risk is meritorious and in keeping with the aspirations of Cicely Saunders for improving the quality of hospice care.

The current study aimed to extend the evaluation of the utility of the Social Performance Rating Scale (SPRS) [Behav. Res. Ther. 36 (1998) 995]. We examined the utility of a modified SPRS for the behavioral assessment of public-speaking anxiety among patients with social phobia (n = 49). The videotaped performance of public-speaking fearful patients in a public-speaking task was rated using four of the five SPRS ratings and was compared to global ratings by patients and observers, as well as to self-report and clinician-administered measures of social anxiety. The pattern of correlations with criterion measures of social anxiety provided evidence for the convergent and divergent validity of this modified SPRS for the behavioral assessment of public-speaking anxiety. Keywords: Social phobia; Public speaking anxiety; Social anxiety; SPRS; Behavioural assessment; Observer ratings

Background: Prior research has demonstrated that the presence of regret and unfinished business is associated with poorer adjustment in bereavement. Though there is a growing literature on these constructs among caregivers of adult patients, the literature on regret and unfinished business in bereaved parents has been limited. Aim: The aim of this study was to examine regret and unfinished business in parents bereaved by cancer, as well as their associations with caregiving experiences and prolonged grief. Design: This was a cross-sectional mixed methods study that utilized self-report questionnaires with open-ended items. Setting/Participants: The multisite study took place at a tertiary cancer hospital and pediatric cancer clinical research institution. Participants were 118 parents (mothers = 82, fathers = 36) who lost a child aged 6 months to 25 years to cancer between 6 months and 6 years prior. Results: Results showed that 73% of the parents endorsed regret and 33% endorsed unfinished business, both of which were more common among mothers than fathers (p ⩽ 0.05). Parents were on average moderately distressed by their regrets and unfinished business, and both regret-related and unfinished business–related distress were associated with distress while caregiving and prolonged grief symptoms. Conclusion: Findings have implications for how providers work with families, including increasing treatment decision-making support, supporting parents in speaking to their child about illness, and, in bereavement, validating choices made. Grief interventions that use cognitive-behavioral and meaning-centered approaches may be particularly beneficial. [ABSTRACT FROM AUTHOR]