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Spatola CAM, Giusti EM, Rapelli G, Goodwin C, Cattivelli R, Pietrabissa G, Malfatto G, Facchini M, Castelnuovo G, Molinari E. Cardiac-specific experiential avoidance predicts change in general psychological well-being among patients completing cardiac rehabilitation. Appl Psychol Health Well Being 2021; 13:715-727. [PMID: 33811743 DOI: 10.1111/aphw.12260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/29/2020] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
Previous studies have shown that experiential avoidance (EA) is associated with physical and psychological well-being in medical and non-medical samples. The aims of the present study were to evaluate the reciprocal association between psychological well-being and EA over time among cardiac rehabilitation (CR) patients with moderately to severely low levels of psychological well-being. Pre-CR data on demographic characteristics, measures of psychological well-being, and cardiac-specific EA were collected from 915 CR patients, as well as post-CR psychological well-being and EA data, from 800 of these patients. A cross-lagged model was estimated to examine the relationship between EA and psychological well-being among patients with moderately to severely low levels of psychological well-being based on questionnaire scores. Both EA and psychological well-being significantly changed during CR and were negatively associated with each other at both pre- and post-CR. Results from cross-lagged structural equation modeling supported a nonreciprocal association between EA and psychological well-being during CR. Pre-CR assessment of EA in patients showing low levels of well-being at the beginning of CR could help to identify patients at risk for worse psychological outcomes. EA could be a promising target of psychological treatments administered during CR.
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Affiliation(s)
- Chiara A M Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emanuele Maria Giusti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Giada Rapelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Christina Goodwin
- Department of Psychiatry & Behavioral Health, Cooper University Health Care, Camden, NJ, USA.,Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gabriella Malfatto
- Department of Cardiovascular, Neurological and Metabolic Sciences, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Mario Facchini
- Department of Cardiovascular, Neurological and Metabolic Sciences, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
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Baziliansky S, Cohen M. Emotion regulation and psychological distress in cancer survivors: A systematic review and meta-analysis. Stress Health 2021; 37:3-18. [PMID: 32720741 DOI: 10.1002/smi.2972] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/26/2020] [Accepted: 06/29/2020] [Indexed: 01/04/2023]
Abstract
Emotion regulation may affect the levels of psychological distress of cancer survivors, but inconsistencies exist among studies regarding the direction of this effect. The systematic review and meta-analysis sought to estimate the associations between emotion regulation patterns (repression, suppression, experiential avoidance and cognitive reappraisal) and psychological distress among cancer survivors. Fifteen studies met inclusion criteria for systematic review, and seven studies focussing on suppression were included in the meta-analysis. The systematic review pointed to a marked variability in associations among the emotion regulation patterns and psychological distress. The three meta-regressions of the relationships between suppression and psychological distress found significant fixed- and random-effect sizes (except marginal significance of a random-effect model for partial correlation). Subgroup analysis showed no moderation effect of time since diagnosis or study quality, but a significant difference (fixed-effect model only, p = 0.005) was found between correlative studies and those controlling for confounders. The current study suggests that suppression is related to elevated levels of psychological distress among cancer survivors, although large inconsistencies exist among studies and publication bias could not be ruled out. Further studies with large samples and a consistent approach are thus required to evaluate the associations of emotion regulation patterns and psychological distress.
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Affiliation(s)
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
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García-Encinas A, Ramírez-Maestre C, Esteve R, López-Martínez AE. Predictors of posttraumatic stress symptoms and perceived health after an acute coronary syndrome: the role of experiential avoidance, anxiety sensitivity, and depressive symptoms. Psychol Health 2020; 35:1497-1515. [PMID: 32404010 DOI: 10.1080/08870446.2020.1761974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 04/24/2020] [Indexed: 02/08/2023]
Abstract
Objectives: The identification of psychological markers of the posttraumatic stress reaction after a cardiac event is relevant in the management of cardiovascular risk factors. The aim of the study to test the contribution of experiential avoidance, anxiety sensitivity, and depressive symptoms to acute coronary syndrome posttraumatic stress symptoms and perceived health (both measured 6 months later), and to determine whether the associations between experiential avoidance, anxiety sensitivity, and depressive symptoms with perceived health were mediated by the posttraumatic stress symptoms.Design: 180 patients with acute coronary syndrome completed a survey over a 6-month period.Results: Anxiety sensitivity and depressive symptoms but not experiential avoidance contributed significantly to posttraumatic stress symptoms. Depressive symptoms and posttraumatic symptoms but neither anxiety sensitivity nor experiential avoidance had a significant association on perceived health. Acute coronary syndrome posttraumatic symptoms significantly mediated the association of depressive symptoms with perceived health. That is, increased depressive symptoms was significantly associated with higher levels of posttraumatic symptoms, which in turn predicted lower levels of perceived health.Conclusions: Understanding the psychological factors that are associated with post-acute coronary syndrome posttraumatic stress symptoms may help to identify patients at risk in order to refer them to the appropriate psychological care service.
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Affiliation(s)
- Angélica García-Encinas
- Departamento de Personalidad, Evaluación y Tratamiento, Facultad de Psicología y Logopedia, Universidad de Málaga, Servicio de salud mental, Hospital Universitario Parc Taulí de Sabadell, Sabadell, Spain
| | - Carmen Ramírez-Maestre
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología y Logopedia, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Rosa Esteve
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología y Logopedia, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Alicia E López-Martínez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología y Logopedia, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
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Coutinho M, Trindade IA, Ferreira C. Experiential avoidance, committed action and quality of life: Differences between college students with and without chronic illness. J Health Psychol 2019; 26:1035-1045. [DOI: 10.1177/1359105319860167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to explore, through structural equation modelling, experiential avoidance and committed action’s effects on the association between anxiety and psychological quality of life and whether this relationship presents significant differences across a sample of 115 college students with chronic illness and a sample of 232 students without illness. Students with chronic illness presented higher levels of anxiety and experiential avoidance and lower levels of quality of life. The association between anxiety and psychological quality of life was partially explained by experiential avoidance and committed action. This path model was shown to be invariant between the two groups of students.
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Affiliation(s)
- Mariana Coutinho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Portugal
| | - Inês A Trindade
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Portugal
| | - Cláudia Ferreira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Portugal
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