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Earnshaw VA, Sepucha KR, Laurenceau JP, Subramanian SV, Hill EC, Wallace J, Brousseau NM, Henderson C, Brohan E, Morrison LM, Kelly JF. Disclosing Recovery: A pilot randomized controlled trial of a patient decision aid to improve disclosure processes for people in treatment for opioid use disorder. J Subst Use Addict Treat 2024; 160:209291. [PMID: 38272118 PMCID: PMC11060902 DOI: 10.1016/j.josat.2024.209291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION People engaged in treatment for opioid use disorder (OUD) report struggling with whether and how to disclose, or share information about their OUD history and/or treatment with others. Yet, disclosure can act as a gateway to re-establishing social connection and support during recovery. The current study describes a pilot randomized controlled trial of Disclosing Recovery: A Decision Aid and Toolkit, a patient decision aid designed to facilitate disclosure decisions and build disclosure skills. METHODS Participants (n = 50) were recruited from a community-based behavioral health organization in 2021-2022 and randomized to receive the Disclosing Recovery intervention versus an attention-control comparator. They responded to surveys immediately after receiving the intervention as well as one month following the intervention at a follow-up appointment. Primary outcome analyses examined indicators of implementation of the intervention to inform a future efficacy trial. Secondary outcome analyses explored impacts of the intervention on the decision-making process, disclosure rates, and relationships. RESULTS Participants were successfully recruited, randomized, and retained, increasing confidence in the feasibility of future efficacy trials to test the Disclosing Recovery intervention. Moreover, participants in the Disclosing Recovery intervention agreed that the intervention is acceptable, feasible, and appropriate. They additionally reported a higher quality of their decision-making process and decisions than participants in the comparator condition. At their follow-up appointment, participants with illicit opioid use who received the Disclosing Recovery intervention were less likely to disclose than those who received the comparator condition. Moreover, significant interactions between illicit opioid use and the intervention condition indicated that participants without illicit opioid use who received the Disclosing Recovery intervention reported greater closeness to and social support from their planned disclosure recipient than those who received the comparator condition. CONCLUSIONS The Disclosing Recovery intervention appears to be an acceptable, feasible, and appropriate patient decision aid for addressing disclosure processes among people in treatment for OUD. Moreover, preliminary results suggest that it shows promise in improving relationship closeness and social support in patients without illicit opioid use. More testing is merited to determine the intervention's efficacy and effectiveness in improving relationship and treatment outcomes for people in treatment for OUD.
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Affiliation(s)
- Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE 19716, USA.
| | - Karen R Sepucha
- Health Decision Sciences Center, Massachusetts General Hospital, 100 Cambridge St, Suite 1600, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
| | - Jean-Philippe Laurenceau
- Department of Psychological and Brain Sciences, University of Delaware, 231 Wolf Hall, Newark, DE 19716, USA.
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - E Carly Hill
- Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE 19716, USA; Center for Research on Education and Social Policy, University of Delaware, 125 Academy Street, Newark, DE 19716, USA.
| | - James Wallace
- Center for Research on Education and Social Policy, University of Delaware, 125 Academy Street, Newark, DE 19716, USA; Department of Epidemiology, University of Delaware, 100 Discovery Blvd, Newark, DE 19716, USA.
| | - Natalie M Brousseau
- Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Rd, Piscataway, NJ 08854-8020, USA.
| | - Claire Henderson
- Health Services and Population Research Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, United Kingdom of Great Britain and Northern Ireland.
| | - Elaine Brohan
- Health Services and Population Research Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, United Kingdom of Great Britain and Northern Ireland.
| | - Lynn M Morrison
- Brandywine Counseling and Community Services, 2713 Lancaster Avenue, Wilmington, DE 19805, USA.
| | - John F Kelly
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac St, 6th Floor, Boston, MA 02114, USA.
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Covington LB, Ji X, Laurenceau JP, Patterson F, Brownlow JA. Exploration of Sex and Age as Moderators Between Social Cumulative Risk and Sleep in a Representative Sample of Children and Adolescents Living in the United States. Int J Behav Med 2024; 31:229-240. [PMID: 37097599 PMCID: PMC10654561 DOI: 10.1007/s12529-023-10175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Youth who face adversity are at a disproportionate risk for poor sleep health across the life course. Identifying whether the association between adversity and poor sleep varies based upon age and sex is needed. This study aims to explore sex and age as moderators between social risk and sleep in a sample of U.S. youth. METHODS This study analyzed data of 32,212 U.S. youth (6-17 years) whose primary caregiver participated in the 2017-2018 National Survey of Children's Health. A social cumulative risk index (SCRI) score was calculated from 10 parental, family, and community risk indicators. Nighttime sleep duration was the number of hours the child slept during the past week. Weeknight sleep irregularity was operationalized as whether the child sometimes/rarely/never went to bed at the same time. Generalized logistic regression models estimated associations between SCRI and sleep duration/irregularity, with age and sex as moderators. RESULTS Age moderated the association between SCRI and short sleep (OR = 1.12, p < 0.001), such that the magnitude of the SCRI-sleep relationship was 12% greater in school-age children. Sex was not a significant moderator. In stratified models by age group, age was positively associated with short sleep in both groups, with a greater magnitude in school-age children. Female school-age children were less likely to have short sleep than males. CONCLUSIONS Younger children with greater social cumulative risk factors may be more vulnerable to short sleep duration. Further research into the mechanisms underlying the relationships between social risk and sleep health in school-age children is needed.
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Affiliation(s)
- Lauren B Covington
- School of Nursing, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE, 19713, USA.
| | - Xiaopeng Ji
- School of Nursing, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE, 19713, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological and Brain Sciences, University of Delaware, 105 The Green, Newark, DE, 19716, USA
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE, 19713, USA
| | - Janeese A Brownlow
- Department of Psychology, Delaware State University, 1200 N. DuPont Highway, Dover, DE, 19901, USA
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Shrout MR, Weigel DJ, Laurenceau JP. Couples and concealable chronic illness: Investigating couples' communication, coping, and relational well-being over time. J Fam Psychol 2024; 38:136-148. [PMID: 37616088 PMCID: PMC10843698 DOI: 10.1037/fam0001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Couples managing chronic illnesses-the leading causes of death and disability in the United States-can experience challenges in their daily lives and relationships. Both couple members have reported lower satisfaction, greater burden, and communication difficulties. Many of these illnesses are nonvisible or concealable, increasing fear and uncertainty when sharing illness information, and reducing self-disclosure. These challenges can leave couples vulnerable to dissatisfaction and distress. In this longitudinal study, we integrated dyadic coping frameworks to examine how couples' communication and coping predicted relational well-being over time. Couples, where one partner was diagnosed with a concealable chronic illness, completed three online surveys 6 months apart (n = 242 couples at baseline, 146 couples at 6 months, and 123 couples at 12 months). Couples were recruited from university settings. Actor-partner interdependence mediation models using within-person multilevel dyadic path modeling tested the theoretical model. For patient and partner actor effects, at times when they saw the illness as shared and something that they could manage together, the more they talked about the illness and used dyadic coping strategies (p < .001). In turn, when using dyadic coping strategies more often, patients and partners felt more satisfied, close, and sexually satisfied than they typically felt that year (p < .001). For cross-partner effects, when patients talked about the illness more than usual, their partners also used dyadic coping strategies more often (p = .01). Patients' open communication may not only benefit themselves but also their partners. This multifaceted approach offers new insight into promoting relational well-being while managing concealable chronic illness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- M. Rosie Shrout
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
| | - Daniel J. Weigel
- Human Development and Family Science, Interdisciplinary Social Psychology PhD Program, University of Nevada, Reno, Reno, NV, USA
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Müller F, van Dongen S, van Woezik R, Tibosch M, Tuinman MA, Schellekens MPJ, Laurenceau JP, van der Lee M, Hagedoorn M. A Web-Based Mindfulness-Based Cognitive Therapy for Couples Dealing With Chronic Cancer-Related Fatigue: Protocol for a Single-Arm Pilot Trial. JMIR Res Protoc 2023; 12:e48329. [PMID: 37930767 PMCID: PMC10660231 DOI: 10.2196/48329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/04/2023] [Accepted: 08/29/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Chronic fatigue is a common symptom among patients who have been treated for cancer. Current psychosocial interventions typically target the patient alone, despite growing evidence suggesting that a couples' approach can increase and broaden the efficacy of an intervention. Therefore, based on an existing web-based mindfulness-based cognitive therapy for patients, the couple intervention COMPANION was developed. OBJECTIVE The primary objectives of this study are to determine the acceptability of COMPANION and its potential efficacy in reducing fatigue in patients with cancer. Our secondary objectives are to examine the feasibility of the trial procedures and the potential working mechanisms of the couple intervention. METHODS We will conduct a single-arm pilot trial for couples (ie, patients with cancer with chronic fatigue and their partners). All couples are allocated to the web-based couple intervention that consists of psychoeducation, mindfulness, and cognitive-behavioral exercises. The 9 sessions of the intervention are supervised remotely by a trained therapist. Patients and partners will complete questionnaires before starting the intervention (T0), 2 weeks after completing the intervention (T1), and 1 month after T1 (T2). They will also fill out weekly diaries during the intervention period. A subsample of patients (n≈5) and partners (n≈5) as well as all the therapists providing COMPANION will participate in the final focus groups. Benchmark values have been defined to determine the acceptability (ie, ≥60% of couples complete the intervention and/or ≥70% of the participants are satisfied with the intervention) and potential efficacy (ie, a significant improvement in fatigue and/or a clinically relevant improvement in fatigue in 45% of the patients between T0 and T1) of the intervention. The trial procedures are deemed feasible if an average of at least three couples are included per recruiting month and/or adherence to the assessments is at least 65% for T1 and the diaries and 60% for T2. To establish potential working mechanisms, changes in affect, sleep, catastrophizing, partner communication and interactions, self-efficacy, mindfulness, and closeness will be examined. Quantitative outcomes will be interpreted along with the results from the focus groups. RESULTS Data collection is expected to be completed by March 2024. CONCLUSIONS This pilot trial will test the first web-based mindfulness-based cognitive therapy for couples targeting chronic cancer-related fatigue. Findings will indicate whether proceeding with a randomized controlled trial is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT05636696; https://clinicaltrials.gov/study/NCT05636696. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48329.
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Affiliation(s)
- Fabiola Müller
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sophie van Dongen
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
| | - Rosalie van Woezik
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
| | - Marijke Tibosch
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
| | - Marrit A Tuinman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Melanie P J Schellekens
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Jean-Philippe Laurenceau
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Marije van der Lee
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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5
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Brousseau NM, Karpyn A, Laurenceau JP, Farmer HR, Kelly JF, Hill EC, Earnshaw VA. The Impacts of Social Support and Relationship Characteristics on Commitment to Sobriety Among People in Opioid Use Disorder Recovery. J Stud Alcohol Drugs 2022; 83:646-652. [PMID: 36136434 PMCID: PMC9523758 DOI: 10.15288/jsad.21-00225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/23/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Despite evidence that social support is beneficial for people living with opioid use disorders (OUDs), research has yet to investigate whether social support within certain relationships is more or less effective. The current study examined whether social support, relationship closeness with a disclosure partner, and/or the history of joint substance use between participants and disclosure partners affect commitment to sobriety among people receiving medications for OUD. METHOD Over a period of 3 months (two time points), participants taking OUD medications took part in a mixed-methods egocentric social network study exploring their relationships with disclosure partners before and following OUD disclosure (i.e., first telling a disclosure partner about one's OUD history or treatment). Data included 131 disclosure events/relationships clustered within 106 participants. RESULTS Greater relationship closeness was associated with increased commitment to sobriety over time. Further, significant interactions were found between social support and disclosure partner closeness, partner closeness and history of joint substance use, and social support and history of joint substance use. Higher social support was associated with greater commitment to sobriety among those disclosing to close partners. In contrast, receiving social support or disclosing to a close partner with whom there was a history of joint substance use was associated with decreased commitment to sobriety. CONCLUSIONS Findings highlight the complexities of social support among people in treatment for OUD and demonstrate that relationship closeness and a history of joint substance use with a disclosure partner may be important factors to consider before disclosure.
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Affiliation(s)
- Natalie M. Brousseau
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, Connecticut
| | - Allison Karpyn
- Center for Research in Education and Social Policy (CRESP), University of Delaware, Newark, Delaware
- Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware
| | | | - Heather R. Farmer
- Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware
| | - John F. Kelly
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Recovery Research Institute, Massachusetts General Hospital, Boston, Massachusetts
| | - Elizabeth C. Hill
- Center for Research in Education and Social Policy (CRESP), University of Delaware, Newark, Delaware
- Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware
| | - Valerie A. Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware
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Soriano EC, Lenhard MJ, Gonzalez JS, Tennen H, Otto AK, Perndorfer C, Shen BJ, Siegel SD, Laurenceau JP. Momentary Partner Involvement in Diabetes Self-Care and Continuously Measured Glucose: A Dynamic Analysis. Psychosom Med 2022; 84:808-812. [PMID: 35792706 PMCID: PMC9437115 DOI: 10.1097/psy.0000000000001106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined the dynamic, real-time associations between partner involvement in diabetes self-care and continuous glucose monitor (CGM) metrics in adults with type 2 diabetes. METHODS For 1 week, 63 participants wore Dexcom G4 CGMs and provided momentary reports of partner involvement in diabetes self-care five times per day. Dynamic structural equation models were used to estimate the reciprocal lagged effects of partner involvement on next-hour CGM metrics (and vice versa). RESULTS Partner involvement predicted improved next-hour glucose control for five of six CGM metrics in analyses adjusted for time-varying covariates. The hour after partner involvement, the model predicted a 26.34 mg/dl decrease in glucose level (standardized β = -0.19), 30% greater odds of meeting target time in target range ( β = 0.07), 48% higher odds of target time below target range (TBR; β = 0.04; the only nonsignificant effect), 47% greater odds of target time above target range (β = 0.11), a 4.20 unit decrease in glucose standard deviation ( β = -0.19), and a 0.01 unit decrease in glucose coefficient of variation ( β = -0.08; all p values < .05). There was less consistent support for the reverse pathway, with only two metrics significantly related to next-hour partner involvement: glucose level ( β = 0.15) and TBR ( β = 0.21), such that having higher levels and meeting target TBR were significantly predictive of next-hour partner involvement. CONCLUSIONS This is the first study showing that partner involvement in daily diabetes management predicts short-term glucose control. More research is needed to understand how partners influence glycemic control and evaluate interventions that promote their involvement in diabetes care.
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Affiliation(s)
| | - M. James Lenhard
- Christiana Care Health System, Section of Endocrinology and Metabolism
| | - Jeffrey S. Gonzalez
- Yeshiva University, Ferkauf Graduate School of Psychology & Albert Einstein College of Medicine, Dept. of Medicine, Epidemiology, & Population Health
| | - Howard Tennen
- University of Connecticut School of Medicine, Dept. of Community Medicine and Dept. of Psychiatry
| | - Amy K. Otto
- University of Delaware, Dept. of Psychological & Brain Sciences
| | | | | | - Scott D. Siegel
- Christiana Care Health System, Section of Endocrinology and Metabolism
| | - Jean-Philippe Laurenceau
- University of Delaware, Dept. of Psychological & Brain Sciences
- Christiana Care Health System, Section of Endocrinology and Metabolism
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Hoogendoorn CJ, Qin J, Wang C, Roque N, Laurenceau JP, Katz MJ, Derby CA, Lipton RB, Gonzalez JS. Depressive symptoms mediate the relationship between diabetes and cognitive performance in a community-based sample of older adults. J Diabetes Complications 2022; 36:108183. [PMID: 35718600 DOI: 10.1016/j.jdiacomp.2022.108183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 02/07/2023]
Abstract
AIMS To evaluate whether diabetes and prediabetes are associated with impaired cognitive performance among older adults and examine depressive symptoms as a mediator. METHODS We used cross-sectional data from the Einstein Aging Study, a systematically recruited, community-based cohort study of diverse older adults (N = 794; Age Mean (SD) = 78.9 (5.3); 64.4% Non-Hispanic White, 28.7% Non-Hispanic Black, 5.7% Hispanic). Diabetes status was established via self-reported diagnosis, prescribed medications, and fasting blood glucose. Depressive symptoms were assessed using the Geriatric Depression Scale. Cognitive tests included Digit Symbol, Trails-B, Free Recall, Category Fluency, Boston Naming, and Block Design. Linear regression and mediation analyses were applied. RESULTS Compared to those without diabetes, diabetes was associated with worse performance on all cognitive tests (ps < 0.05), except Trails-B (p = 0.53), and increased depressive symptoms (p < 0.01). For diabetes, mediation via increased depressive symptoms was observed for Free Recall (p = 0.044), Category Fluency (p = 0.033), and Boston Naming (p = 0.048). CONCLUSIONS Diabetes was consistently associated with worse cognitive performance and increased depressive symptoms among this older cohort, while prediabetes was not. Mediation findings suggest depressive symptoms may be a biobehavioral pathway linking diabetes and cognition, though the temporal sequence is unclear. If causal, addressing both diabetes and depressive symptoms among older adults may protect cognitive function.
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Affiliation(s)
| | - Jiyue Qin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nelson Roque
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
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Fenech AL, Perndorfer C, Soriano EC, Otto AK, Brownlee HA, Morreale M, Siegel SD, Laurenceau JP. Daily partner responsiveness and everyday sleep outcomes in breast cancer survivors and their partners. Support Care Cancer 2022; 30:7561-7568. [PMID: 35676343 DOI: 10.1007/s00520-022-07195-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Breast cancer (BC) survivors and their intimate partners face several adverse consequences from the cancer experience, including sleep disturbance, which is a common side effect of BC and its treatment. Sleep has been conceptualized and examined as an individual phenomenon despite most adults sharing a bed/room with a partner. Limited research has examined the associations between daily relationship processes and sleep in couples coping with cancer. Using an intensive longitudinal design, the present study examined the daily, within-person links between attempted and perceived partner responsiveness and subjective sleep. METHODS Immediately following adjuvant treatment, 72 early-stage BC survivors and their intimate partners (144 paired individuals) reported on daily attempted and perceived partner responsiveness each evening and subjective sleep each morning for 21 consecutive days. RESULTS Survivor and partner reports of partner responsiveness were associated with their own subjective sleep, such that greater attempted and perceived partner responsiveness were associated with improvements in one's own subjective sleep. Effects of one participant's partner responsiveness on their partner's sleep were not observed. CONCLUSIONS Findings suggest that among couples coping with early-stage BC, increased partner responsiveness is associated with subsequent improvements in subjective sleep. IMPLICATIONS FOR CANCER SURVIVORS Sleep disturbance is a serious concern for BC survivors and their intimate partners. Future research should assess intimacy processes as a potential method to improve BC survivor and partner sleep.
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Affiliation(s)
- Alyssa L Fenech
- Department of Psychological & Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA.
| | - Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA
| | - Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA
| | - Amy K Otto
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Hannah A Brownlee
- Department of Psychological & Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA
| | - Michael Morreale
- Department of Psychological & Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA
| | - Scott D Siegel
- Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological & Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA.
- Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, USA.
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9
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Perndorfer C, Soriano EC, Siegel SD, Spencer RMC, Otto AK, Laurenceau JP. Fear of Cancer Recurrence and Sleep in Couples Coping With Early-Stage Breast Cancer. Ann Behav Med 2022; 56:1131-1143. [PMID: 35551585 PMCID: PMC9635995 DOI: 10.1093/abm/kaac018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) and sleep disturbance are common in cancer survivors. Yet, little research has examined their relationship, and even less is known about what links may exist between these variables among the intimate partners of cancer survivors. PURPOSE This study examines the relationship between FCR and sleep disturbance in breast cancer survivors and their partners. Using daily sleep data collected at two distinct periods early in survivorship-the completion of adjuvant treatment and the first post-treatment mammogram-higher survivor and partner FCR was hypothesized to predict greater sleep disturbance. METHODS Breast cancer survivors and intimate partners (N = 76 couples; 152 individuals) each reported sleep duration, sleep quality, sleep onset latency, and wake after sleep onset each morning of two 21-day sleep diary bursts during the first year post-diagnosis. Three validated measures formed latent FCR factors for survivors and partners, which were used to predict average daily sleep. RESULTS Across both sleep diary bursts, survivor FCR was associated with their own reduced sleep duration, reduced sleep quality, and greater sleep onset latency. Survivor FCR was also associated with their partners' reduced sleep quality and greater sleep onset latency. Partner FCR was associated with their own reduced sleep duration, reduced sleep quality, and greater sleep onset latency. Partner FCR was also associated with survivors' reduced sleep quality. CONCLUSIONS Findings revealed intrapersonal and interpersonal associations between FCR and sleep disturbance, addressing gaps in knowledge on FCR and an outcome with known short- and long-term implications for health and mortality.
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Affiliation(s)
- Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE 19716, USA
| | - Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE 19716, USA
| | - Scott D Siegel
- Value Institute, Helen F. Graham Cancer Center and Research Institute, Newark, DE 19713, USA
| | - Rebecca M C Spencer
- Department of Psychological & Brain Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Amy K Otto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Le Y, Fredman SJ, Marshall AD, Chow SM, McDaniel BT, Laurenceau JP, Feinberg ME. Relational impacts of capitalization in early parenthood. J Fam Psychol 2022; 36:69-79. [PMID: 33764085 PMCID: PMC8463635 DOI: 10.1037/fam0000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Relationship difficulties are common during the transition to parenthood and may persist for years. Strategies that enhance couples' daily relational experiences early in the parenting years may serve a protective role. In general, engaging in a capitalization attempt (i.e., sharing personal good news) with one's romantic partner and perceiving the partner to be responsive are associated with better relationship outcomes among committed couples. However, it is unknown whether these relational benefits extend to the early parenting years or to other relational domains such as coparenting, which plays a central role in family functioning. The current study examined same-day associations between couples' capitalization process and relationship closeness and perceived coparenting support in a dyadic context during the first year of parenthood. A subsample of primarily non-Hispanic White coresident mixed-gender couples who participated in a randomized controlled trial of a transition to parenthood program (N = 141) completed daily diaries at 10 months postpartum for 8 consecutive days. On days when mothers shared, both partners reported greater closeness. On days when fathers shared, mothers reported greater closeness and perceived coparenting support. Furthermore, perceived partner responsiveness was associated with greater closeness for both partners and greater coparenting support for fathers. Fathers also perceived greater closeness and coparenting support on days when mothers shared about the child. Findings highlight the potential benefits of capitalization in early parenthood for both closeness and perceived coparenting support and suggest that capitalization may be a low cost, high yield strategy for enhancing new parents' daily relational experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Yunying Le
- Department of Human Development and Family Studies, The Pennsylvania State University
- Department of Psychology, University of Miami
| | - Steffany J. Fredman
- Department of Human Development and Family Studies, The Pennsylvania State University
| | | | - Sy-Miin Chow
- Department of Human Development and Family Studies, The Pennsylvania State University
| | - Brandon T. McDaniel
- Health Services and Informatics Research, Parkview Mirro Center for Research and Innovation
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11
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Psihogios AM, Rabbi M, Ahmed A, McKelvey ER, Li Y, Laurenceau JP, Hunger SP, Fleisher L, Pai AL, Schwartz LA, Murphy SA, Barakat LP. Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement During Cancer Treatment: Protocol for Ecological Momentary Assessment. JMIR Res Protoc 2021; 10:e32789. [PMID: 34677129 PMCID: PMC8571686 DOI: 10.2196/32789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) with cancer demonstrate suboptimal oral chemotherapy adherence, increasing their risk of cancer relapse. It is unclear how everyday time-varying contextual factors (eg, mood) affect their adherence, stalling the development of personalized mobile health (mHealth) interventions. Poor engagement is also a challenge across mHealth trials; an effective adherence intervention must be engaging to promote uptake. OBJECTIVE This protocol aims to determine the temporal associations between daily contextual factors and 6-mercaptopurine (6-MP) adherence and explore the proximal impact of various engagement strategies on ecological momentary assessment survey completion. METHODS At the Children's Hospital of Philadelphia, AYAs with acute lymphoblastic leukemia or lymphoma who are prescribed prolonged maintenance chemotherapy that includes daily oral 6-MP are eligible, along with their matched caregivers. Participants will use an ecological momentary assessment app called ADAPTS (Adherence Assessments and Personalized Timely Support)-a version of an open-source app that was modified for AYAs with cancer through a user-centered process-and complete surveys in bursts over 6 months. Theory-informed engagement strategies will be microrandomized to estimate the causal effects on proximal survey completion. RESULTS With funding from the National Cancer Institute and institutional review board approval, of the proposed 30 AYA-caregiver dyads, 60% (18/30) have been enrolled; of the 18 enrolled, 15 (83%) have completed the study so far. CONCLUSIONS This protocol represents an important first step toward prescreening tailoring variables and engagement components for a just-in-time adaptive intervention designed to promote both 6-MP adherence and mHealth engagement. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/32789.
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Affiliation(s)
- Alexandra M Psihogios
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Mashfiqui Rabbi
- Department of Statistics, Harvard University, Boston, MA, United States
| | - Annisa Ahmed
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Elise R McKelvey
- Children's Hospital of Philadelphia, La Salle University, Philadelphia, PA, United States
| | - Yimei Li
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Stephen P Hunger
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Linda Fleisher
- Health Communications and Health Disparities, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Ahna Lh Pai
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Lisa A Schwartz
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Susan A Murphy
- Department of Statistics, Harvard University, Boston, MA, United States
| | - Lamia P Barakat
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
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Ramazi R, Perndorfer C, Soriano EC, Laurenceau JP, Beheshti R. Predicting Progression Patterns of Type 2 Diabetes using Multi-sensor Measurements. ACTA ACUST UNITED AC 2021; 21. [PMID: 34568534 DOI: 10.1016/j.smhl.2021.100206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Type 2 diabetes - a prevalent chronic disease worldwide - increases risk for serious health consequences including heart and kidney disease. Forecasting diabetes progression can inform disease management strategies, thereby potentially reducing the likelihood or severity of its consequences. We use continuous glucose monitoring and actigraphy data from 54 individuals with Type 2 diabetes to predict their future hemoglobin A1c, HDL cholesterol, LDL cholesterol, and triglyceride levels one year later. We use a combination of convolutional and recurrent neural networks to develop a deep neural network architecture that can learn the dynamic patterns in different sensors' data and combine those patterns with additional demographic and lab data. To further demonstrate the generalizability of our models, we also evaluate their performance using an independent public dataset of individuals with Type 1 diabetes. In addition to diabetes, our approach could be useful for other serious and chronic physical illness, where dynamic (e.g., from multiple sensors) and static (e.g., demographic) data are used for creating predictive models.
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Affiliation(s)
- Ramin Ramazi
- Department of Computer & Informational Sciences, University of Delaware, Newark, DE, USA
| | - Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | | | - Rahmatollah Beheshti
- Department of Computer & Informational Sciences, University of Delaware, Newark, DE, USA
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Soriano EC, Perndorfer C, Otto AK, Fenech AL, Siegel SD, Dickson-Witmer D, Clements L, Laurenceau JP. Psychosocial Impact of Cancer Care Disruptions in Women With Breast Cancer During the COVID-19 Pandemic. Front Psychol 2021; 12:662339. [PMID: 34194367 PMCID: PMC8236578 DOI: 10.3389/fpsyg.2021.662339] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/28/2021] [Indexed: 01/11/2023] Open
Abstract
Background: The COVID-19 pandemic caused significant disruptions in cancer care, and preliminary research suggests that these disruptions are associated with increased levels of psychosocial distress among cancer survivors. The purpose of this study was to offer a descriptive report of the psychosocial functioning, perceived risk and fear of cancer progression, and COVID-19 pandemic impact and experiences in a unique, high-risk patient cohort: breast cancer survivors whose cancer treatment was delayed and/or changed due to the COVID-19 pandemic. Methods: This cross-sectional study included 50 women with dual carcinoma in situ, lobular carcinoma in situ, or invasive breast cancer whose cancer surgery was postponed due to the pandemic. As they awaited delayed surgery or shortly after they received delayed surgery, participants completed questionnaires on psychosocial functioning (depression, anxiety, sleep, and quality of life), their perceived risk and fear of cancer progression, patient-provider communication about disruptions in their care, personal impact of the pandemic, worry/threat about COVID-19, and COVID-19 symptoms/diagnoses. Descriptive statistics and bivariate correlations were computed among continuous study variables. Independent samples t-tests explored group differences in psychosocial functioning between survivors who were still awaiting delayed surgery and those who had recently received it. Results: Overall, the sample denied that the pandemic seriously negatively impacted their finances or resource access and reported low-to-moderate levels of psychosocial distress and fear about COVID-19. Twenty-six percent had clinically significant levels of fear of cancer progression, with levels comparable to other recent work. About a third were still awaiting delayed cancer surgery and this group reported lower satisfaction with communication from oncology providers but overall did not seem to report more psychosocial difficulties than those who already had surgery. Conclusion: Shortly before or after primary breast cancer surgery that was delayed due to the COVID-19 pandemic, this sample of survivors appears to be generally managing well psychosocially. However, many psychosocial difficulties (e.g., fear of cancer recurrence/progression) typically have an onset after the completion of treatment, therefore, research should continue to follow this cohort of cancer survivors as the pandemic's direct impact on their care likely increases their risk for these difficulties later in survivorship.
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Affiliation(s)
- Emily C. Soriano
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Christine Perndorfer
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Amy K. Otto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Alyssa L. Fenech
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Scott D. Siegel
- Christiana Care Health System, Helen F. Graham Cancer Center and Research Institute, Newark, DE, United States
| | - Diana Dickson-Witmer
- Christiana Care Health System, Helen F. Graham Cancer Center and Research Institute, Newark, DE, United States
| | - Lydia Clements
- Christiana Care Health System, Helen F. Graham Cancer Center and Research Institute, Newark, DE, United States
| | - Jean-Philippe Laurenceau
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
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Covington L, Brewer B, Blair R, Hoopes E, Laurenceau JP, Patterson F. 181 Sleep health concordance among socioeconomically disadvantaged caregiver-child dyads. Sleep 2021. [DOI: 10.1093/sleep/zsab072.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Child and caregiver sleep typically occurs within a family system. Disadvantaged families experience disproportionately poorer sleep health than more advantaged families. The extent to which objectively measured sleep health metrics (e.g. duration, timing, regularity, efficiency) are concordant within disadvantaged family systems, such as caregiver-child dyads, is not clear. To address this gap, this study aimed to: (1) characterize sleep health metrics, and (2) identify levels of sleep health concordance among disadvantaged caregiver-child dyads.
Methods
23 disadvantaged dyads were recruited from Philadelphia and Delaware communities. Dyads were eligible if the child was between 6-14 years, slept in the same house as the caregiver at least four nights/week, had no diagnosis of a sleep disorder or use of sleep medication, and qualified for federally funded food assistance programs (e.g., food stamps, WIC or SNAP benefits). Sleep health of the dyads was objectively measured for 7-14 days. Sleep metrics used to characterize the sample were: nighttime sleep duration (hours), time-to-bed, sleep regularity (standard deviation of sleep duration), sleep midpoint (halfway point between sleep onset and wake time) and efficiency (percentage of time spent asleep versus awake). Concordance in sleep health metrics within dyads was calculated using Pearson’s correlation coefficients of the average sleep metrics over the monitoring period.
Results
Children (46.2% female) slept, on average, 7.96 hours per night, with 1.25 hours of nightly sleep variability, bedtime of 10:47 PM, sleep midpoint of 2:56 AM, and sleep efficiency of 83.55%. Caregivers (mean age = 40.5 years, 85.0% female) slept, on average, 6.92 hours per night, with 1.22 hours of nightly sleep variability, bedtime of 11:24 PM, sleep midpoint of 3:04 AM, and sleep efficiency of 76.29%. Bedtime (r = 0.19, p < 0.001), sleep midpoint (r = 0.39, p < 0.001), and sleep efficiency (r = 0.24, p < 0.001) were significantly concordant among caregiver-child dyads.
Conclusion
Given their level of concordance, bedtime, sleep midpoint and efficiency are modifiable factors of sleep health in disadvantaged dyads that could be targeted using family versus individual level interventions.
Support (if any)
University of Delaware General University Research Grant and School of Nursing SEED funding.
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Covington L, Ji X, Brownlow J, Laurenceau JP. 637 Cumulative risk associated with poor sleep health in children and adolescents. Sleep 2021. [DOI: 10.1093/sleep/zsab072.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Social risk factors are associated with poor sleep outcomes across the life course. It is unclear if this association varies based on biological factors, such as age and gender. Therefore, the purpose of this analysis was to identify if age or gender moderated the association between cumulative risk and sleep duration/regularity in a national sample of children and adolescents.
Methods
We completed a secondary data analysis using the National Survey of Children’s Health 2017–2018 publicly available dataset. In a sample of 36,997 children age 6–17 years, we explored the association between a social cumulative risk index score (CRI) and child sleep duration and regularity. We included eight dichotomous social risk variables in the CRI: parental education
Results
Age was a significant moderator of the association between CRI and short sleep duration, such that the magnitude of the CRI-sleep relationship was greater in school-age children (age 6–11; b = -0.13, p<0.001) compared to adolescents (age 12–17 years; b = -0.05, p<0.001). Age was not a significant moderator between CRI and sleep irregularity. However, CRI independently predicted increased odds of sleep irregularity (OR = 1.30, p<.001) and older age moderately increased the odds of sleep irregularity (OR = 1.21, p = 0.06). Sex was not a significant moderator of the association between CRI and sleep duration or sleep regularity. However, female sex was positively associated with sleep duration (b = 0.06, p = 0.11), but was not a significant independent predictor of sleep irregularity.
Conclusion
Younger children with cumulative risk factors are at risk for short sleep duration. Further research is needed to uncover biological mechanisms underlying multiple sleep parameters across developmental ages.
Support (if any):
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Soriano EC, Otto AK, LoSavio ST, Perndorfer C, Siegel SD, Laurenceau JP. Fear of Cancer Recurrence and Inhibited Disclosure: Testing the Social-Cognitive Processing Model in Couples Coping With Breast Cancer. Ann Behav Med 2021; 55:192-202. [PMID: 32608472 PMCID: PMC7980765 DOI: 10.1093/abm/kaaa043] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Withholding cancer-related concerns from one's partner (protective buffering) and feeling that one's partner is inaccessible or unresponsive to such disclosure (social constraints) are two interpersonal interaction patterns that separately have been linked to poorer adjustment to cancer. PURPOSE Guided by the Social-Cognitive Processing Model, we examined the joint effects of social constraints and protective buffering on fear of cancer recurrence (FCR) in survivors and spouses. Social constraints and protective buffering were hypothesized to emerge as independent predictors of higher FCR. METHODS Early-stage breast cancer survivors and spouses (N = 79 couples; 158 paired individuals) completed up to five repeated measures of FCR, social constraints, protective buffering, and relationship quality during the year postdiagnosis. A second-order growth curve model was estimated and extended to test the time-varying, within-person effects of social constraints and protective buffering on a latent FCR variable, controlling for relationship quality. RESULTS As hypothesized, greater social constraints and protective buffering significantly (p < .05) predicted higher concurrent FCR at the within-person level, controlling for global relationship quality and change in FCR over time. The fixed effects were found to be similar for both survivors and spouses. CONCLUSIONS Findings suggest that interaction patterns resulting in inhibited disclosure are associated with greater FCR for both survivors and spouses, consistent with the Social-Cognitive Processing Model. This work adds to the growing body of research highlighting the social context of FCR.
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Affiliation(s)
- Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Amy K Otto
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Stefanie T LoSavio
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Scott D Siegel
- Value Institute, Christiana Care Health System, Newark, DE, USA
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Soriano EC, Lenhard JM, Gonzalez JS, Tennen H, Chow SM, Otto AK, Perndorfer C, Shen BJ, Siegel SD, Laurenceau JP. Spousal Influence on Diabetes Self-care: Moderating Effects of Distress and Relationship Quality on Glycemic Control. Ann Behav Med 2021; 55:123-132. [PMID: 32491154 DOI: 10.1093/abm/kaaa038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. PURPOSE We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. METHODS Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. RESULTS The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. CONCLUSIONS This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.
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Affiliation(s)
- Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - James M Lenhard
- Section of Endocrinology and Metabolism, Christiana Care Health System, Wilmington, DE, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University; Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Howard Tennen
- Department of Community Medicine and Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Sy-Miin Chow
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA, USA
| | - Amy K Otto
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Biing-Jiun Shen
- Division of Psychology, School of Humanities and Social Sciences, Nanyang Technological University, Singapore
| | - Scott D Siegel
- Value Institute, Christiana Care Health System, Wilmington, DE, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA.,Helen F. Graham Cancer Center, Christiana Care Health System, Wilmington, DE, USA
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Brown ED, Holochwost SJ, Laurenceau JP, Garnett ML, Anderson KE. Deconstructing Cumulative Risk: Poverty and Aspects of Instability Relate Uniquely to Young Children's Basal Cortisol. Child Dev 2021; 92:1067-1082. [PMID: 33400295 DOI: 10.1111/cdev.13512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study deconstructs cumulative risk to probe unique relations to basal cortisol for family income and four distinct aspects of poverty-related instability. Participants were 288 children aged 3-5 years who attended Head Start preschool. Parents reported on poverty risks. Children provided samples of salivary cortisol at four times of day on 6 days. Results of hierarchical linear modeling with piecewise latent growth curves representing basal cortisol indicated unique relations for family income, household chaos, neighborhood risk, attachment-disruptive residential changes, and non-attachment changes. The findings support an equifinality implied by cumulative risk models in demonstrating that multiple risks relate to cortisol dysregulation yet also suggest the utility of considering unique effects of different risks for neurophysiological stress response functioning.
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Abstract
OBJECTIVE Rumination, thinking about a negative mood repetitively, is a common cognitive process that may affect health behavior engagement or avoidance. Little research has examined relations between rumination and health behaviors. PURPOSE We aimed to test links between rumination and health behaviors as well as possible moderators and mediators of those links. METHODS We used an 11-day online daily diary design. Health behavior outcomes included fruit intake, vegetable intake, exercise, alcohol intake, sexual risk taking behavior, and cigarette smoking. RESULTS Rumination was related to alcohol intake at the within-person level. Using multivariate modeling, we found that significant within-person mediators for rumination to health behaviors included impulsivity, amotivation, self control, and using health behaviors as coping, with each of these mediating relationships for one to four out of the five health behavior outcomes. A significant between-person moderator includes perceived behavioral control for alcohol intake only, and intention was not a significant moderator of the rumination to health behavior relationships. CONCLUSIONS Rumination affects various maladaptive health behaviors differentially, through a number of mechanisms and under a moderating condition whereby those who feel more control are better able to buffer rumination's deleterious effects. Future interventions can apply the results to individual and multiple behavior change interventions for chronic disease prevention, especially for those who are particularly suffering from ruminative thoughts.
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Affiliation(s)
- Kristen E Riley
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ, USA
| | - Crystal L Park
- Department of Psychological Science, University of Connecticut, Storrs, CT, USA
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Soriano EC, Valera R, Pasipanodya EC, Otto AK, Siegel SD, Laurenceau JP. Checking Behavior, Fear of Recurrence, and Daily Triggers in Breast Cancer Survivors. Ann Behav Med 2020; 53:244-254. [PMID: 29771272 DOI: 10.1093/abm/kay033] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a top ongoing concern of breast cancer (BC) survivors and thus the focus of recent intervention development. The Self-Regulation Model of FCR (Lee-Jones C, Humphris G, Dixon R, Hatcher MB. Fear of cancer recurrence-a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psychooncology. 1997;6:95-105.) states that everyday cancer-related events trigger FCR, which, in turn, leads to specific behavioral responses, including checking the body for signs or symptoms of cancer. Links between triggering events, FCR, and checking behavior have not yet been studied in the context of daily life or at the within-person level. PURPOSE The goal of this study was to examine whether FCR has a within-person link with daily checking behavior and whether FCR mediates the link between triggering events and checking behavior. METHODS Seventy-two early-stage BC survivors completed daily diaries over a 21-day period approximately 5 months after BC surgery. FCR, checking behavior, and triggering events were assessed each evening. RESULTS Multilevel modeling results indicated that FCR predicted greater odds of same-day, but not next-day, checking behavior. We found that daily FCR significantly mediated the same-day effect of triggering events on checking behavior. These average within-person effects varied substantially between patients and were not explained by momentary negative affect. CONCLUSIONS Findings support the within-person relationship between triggering events, FCR, and checking behavior posited by guiding theory, and can inform FCR intervention development.
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Affiliation(s)
- Emily C Soriano
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Rosmeiry Valera
- Department of Psychology, Bloomfield College, Bloomfield, NJ, USA
| | | | - Amy K Otto
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Scott D Siegel
- Helen F. Graham Cancer Center & Research Institute, Newark, DE, USA
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Müller F, Hagedoorn M, Soriano EC, Stephenson E, Smink A, Hoff C, DeLongis A, Laurenceau JP, Tuinman MA. Couples' catastrophizing and co-rumination: Dyadic diary study of patient fatigue after cancer. Health Psychol 2019; 38:1096-1106. [PMID: 31580128 DOI: 10.1037/hea0000803] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Fatigue is a prevalent and long-lasting symptom among patients with cancer that is known to be worsened by patients' catastrophizing thoughts about their fatigue. Spouses are also burdened by patient fatigue, which may lead them to catastrophize as well. Based on the dyadic coping literature, this study hypothesized that patient and spouse catastrophizing translate into worse fatigue through co-rumination-couples' communications dwelling on the negative aspects of fatigue (H1). While maladaptive for fatigue, co-rumination also was expected to foster couple relationship satisfaction (H2). METHOD Posttreatment patients with cancer and their spouses (n = 101 dyads) completed daily diaries for 14 days. Patients reported on their momentary fatigue severity. Both couple members reported on their catastrophizing about the patients' fatigue, co-rumination, and their momentary relationship satisfaction. Multilevel structural equation modeling was applied to test within-person actor- and partner-effects between catastrophizing, co-rumination, and changes in fatigue (H1) and between co-rumination and changes in relationship satisfaction (H2). RESULTS Whereas patient catastrophizing was directly related to their fatigue (b = 0.52, 95% credibility interval [CI] [0.09, 0.95]), as hypothesized, the effect of spouse catastrophizing on patient fatigue was mediated through co-rumination (indirect effect = 0.32, 95% CI [0.07, 0.60]). Unexpectedly, patient- and spouse-reported co-rumination were unrelated to both couple members' relationship satisfaction. CONCLUSIONS Spouse catastrophizing contributes to patient fatigue severity through couples' ruminative communications. Co-rumination was not related to relationship satisfaction. Reducing patient and spouse catastrophizing and fostering adaptive dyadic communication in daily life could be targets for future interventions aiming to relieve fatigue in patients after completion of cancer treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Riley KE, Cruess DG, Park CL, Tigershtrom A, Laurenceau JP. Anxiety and Depression Predict the Paths Through Which Rumination Acts on Behavior: A Daily Diary Study. Journal of Social and Clinical Psychology 2019. [DOI: 10.1521/jscp.2019.38.5.409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Rumination—thinking passively, negatively, and repetitively—is a common cognitive process that is associated with poor health behaviors. Rumination impacts health behaviors through two distinct behavioral pathways: acting too quickly (impulsivity) or not acting at all (amotivation), though no research to date has examined the conditions under which rumination may manifest in these two disparate behavioral paths. The presence of anxiety and depression may lead to the behavioral manifestations of rumination, which may then differentially impact health behavior patterns. In this study, we tested whether individuals reporting anxiety who ruminate will then act impulsively and individuals reporting depression who ruminate will then not act in the context of their daily health behaviors. Methods: We recruited 285 college students (mean age = 19.3; 76.8% female; 79.4% Caucasian) and had them complete a baseline survey and an 11-day online daily diary to assess associations among anxiety, depression, rumination, and health behaviors. Results: Rumination predicted health behaviors through both impulsivity and amotivation as expected. Moderation models revealed that rumination in the context of anxiety leads to impulsivity and rumination in the context of depression leads to amotivation. Limitations: The undergraduate sample limits the generalizability of this data. Discussion: These results show that those who report depression or anxiety are likely to experience more daily rumination and the deleterious behavioral manifestations of that rumination, which then affects health behavior engagement or avoidance. Future behavioral health interventions can perhaps specifically target impulsivity among individuals reporting anxiety and amotivation among individuals reporting depression in order to promote more healthy behaviors.
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Le Y, Fredman SJ, McDaniel BT, Laurenceau JP, Feinberg ME. Cross-day influences between couple closeness and coparenting support among new parents. J Fam Psychol 2019; 33:360-369. [PMID: 30570281 PMCID: PMC6449211 DOI: 10.1037/fam0000489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The couple and coparenting relationships are demonstrated to be prospectively and bidirectionally associated over months to years during the early parenting years. However, little is known about these associations at the daily level within the first year of parenthood, when coparenting first emerges. The goal of the current study was to examine the association between couples' daily feelings of relationship closeness and coparenting support in first-time parents and determine directionality of these effects using a dyadic daily diary design. At 10 months postpartum, heterosexual couples (N = 141 dyads) completed daily diaries for 8 consecutive days. An autoregressive cross-lagged model was incorporated within an Actor Partner Interdependence Modeling framework to examine at the daily level: (a) within-person cross-day associations between relationship closeness and coparenting support, (b) cross-partner cross-day associations within relationship closeness and coparenting support, (c) cross-partner cross-day associations between relationship closeness and coparenting support, and (d) gender differences in these associations. Results revealed a prospective, within person bidirectional link between daily relationship closeness and perceived coparenting support for both mothers and fathers. Additionally, an indirect effect from mothers' experiences of coparenting support to fathers' relationship closeness through fathers' experiences of coparenting support was found at the daily level. Findings highlight the interdependent nature of the couple and coparenting relationship at the daily level during the first year of parenthood and suggest that mothers' feeling supported by their coparenting partners may facilitate a "virtuous cycle" between coparenting support and relationship closeness early in the coparenting relationship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Yunying Le
- Department of Human Development and Family Studies
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Soriano EC, Perndorfer C, Siegel SD, Laurenceau JP. Threat sensitivity and fear of cancer recurrence: a daily diary study of reactivity and recovery as patients and spouses face the first mammogram post-diagnosis. J Psychosoc Oncol 2019; 37:131-144. [PMID: 30590993 PMCID: PMC6476641 DOI: 10.1080/07347332.2018.1535532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Fear of cancer recurrence (FCR) is a top concern of breast cancer (BC) survivors and their spouses, yet little is known about responses to FCR triggers in daily life. We examined whether a biologically based individual difference-threat sensitivity-predicted FCR in couples facing the first post-diagnosis mammogram (MMG). We hypothesized that threat sensitivity would predict greater FCR reactivity before the MMG and higher peak FCR on the MMG day, controlling for global anxiety. We also explored the link between threat sensitivity and FCR recovery after MMG. DESIGN AND SAMPLE Fifty-seven early-stage BC patients and their spouses completed cross-sectional measures of threat sensitivity and global anxiety. Couples then reported daily FCR during a 3-week diary period that began 2 weeks before the patient's MMG appointment. METHODS Multilevel actor-partner interdependence modeling was used to estimate within-person random slopes of FCR before (reactivity) and after (recovery) the MMG. Random intercepts captured individual differences in peak FCR on the MMG day. Patient and spouse threat sensitivity and anxiety were entered as predictors of reactivity, peak, and recovery. FINDINGS FCR increased leading to MMG; however, inconsistent with hypotheses, this reactivity was not significantly predicted by threat sensitivity. Actor, but not partner, effects for peak FCR emerged, such that patients and spouses with greater threat sensitivity had greater FCR on the MMG day. FCR decreased after the MMG, and spouse, but not patient, threat sensitivity predicted slower recovery for both partners. CONCLUSIONS Findings lend preliminary support for the role of threat sensitivity in the experience of FCR as couples confront threatening events in BC survivorship. Implications for psychosocial providers: MMGs can be a triggering event for couples. Threat sensitivity may help identify those who are likely to experience elevations in FCR during this stressful period.
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Affiliation(s)
| | | | - Scott D Siegel
- b Helen F. Graham Cancer Center and Research Institute, Newark , Delaware , USA
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Weinstein AG, Singh A, Laurenceau JP, Skoner DP, Maiolo J, Sharara R, Ma K, Cheema T, Butler E, Kong A, Thakkar P, Gentile DA. A Pilot Study of the Effect of an Educational Web Application on Asthma Control and Medication Adherence. J Allergy Clin Immunol Pract 2019; 7:1497-1506. [PMID: 30641146 DOI: 10.1016/j.jaip.2018.12.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND An Asthma Adherence Pathway (AAP) application, which is an Internet application that combines patient and clinician education strategies to promote adherence to asthma therapy, has been developed. OBJECTIVE The primary objective of this pilot study was to evaluate the effectiveness of the AAP application with electronic adherence monitors on asthma control. Secondary objectives evaluated the effect of AAP and monitors on medication adherence, asthma symptoms, quality of life, psychosocial factors, and barriers to treatment. METHODS Adult patients with asthma were randomly assigned either to intervention (n = 19) or control (n = 20) groups in this 3-month prospective study, and they completed the Asthma Control Questionnaire (ACQ). Intervention patients completed the AAP software and were given barrier-specific motivational interviewing adherence strategies and a SmartTrack device to monitor mometasone furoate/formoterol (MF/F) use. Clinicians in the interventional group received adherence management training. Interventional patients were given feedback regarding adherence findings at each visit. Treatment adherence was determined by the mean of 4 measures of doses taken over 3 months. Control patients were not monitored for MF/F adherence. RESULTS The mean MF/F adherence in the intervention group was 81%. The intervention and control groups did not differ on the mean baseline ACQ. Thirteen intervention patients achieved the minimal important difference (defined as an improvement ≥0.5 units on the ACQ) compared with 6 control patients (P = .016). The intervention group showed greater improvement in the ACQ (0.75) than the control group (0.19) representing a moderate-to-large effect size of d = 0.638. CONCLUSIONS The AAP was effective in promoting adherence and helped to improve asthma control. These findings provide preliminary validation of the AAP model.
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Affiliation(s)
- Andrew G Weinstein
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa.
| | - Anil Singh
- Department of Pulmonary and Critical Care, Allegheny General Hospital, Pittsburgh, Pa
| | | | - David P Skoner
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WVa
| | - Jennifer Maiolo
- Department of Rheumatology, Allegheny General Hospital, Pittsburgh, Pa
| | - Rihab Sharara
- Department of Pulmonary and Critical Care, Allegheny General Hospital, Pittsburgh, Pa
| | - Kiet Ma
- Department of Pulmonary and Critical Care, Allegheny General Hospital, Pittsburgh, Pa
| | - Tariq Cheema
- Department of Pulmonary and Critical Care, Allegheny General Hospital, Pittsburgh, Pa
| | - Erica Butler
- Department of Allergy, Asthma, and Immunology, Pediatric Alliance, Pittsburgh, Pa
| | - Allison Kong
- Department of Allergy, Asthma, and Immunology, Allegheny General Hospital, Pittsburgh, Pa
| | - Payal Thakkar
- Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pa
| | - Deborah A Gentile
- Department of Allergy, Asthma, and Immunology, Pediatric Alliance, Pittsburgh, Pa
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Perndorfer C, Soriano EC, Siegel SD, Laurenceau JP. Everyday protective buffering predicts intimacy and fear of cancer recurrence in couples coping with early-stage breast cancer. Psychooncology 2018; 28:317-323. [PMID: 30426612 DOI: 10.1002/pon.4942] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/29/2018] [Accepted: 11/07/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Patient and spouse/partner mutual self-disclosure is central for maintaining intimacy and cognitive processing when transitioning to life after cancer. Protective buffering inhibits self-disclosure and is defined as efforts to protect one's partner from upset and burden by hiding or denying cancer-related concerns. Intimacy and fear of cancer recurrence (FCR) are important determinants of individual and couple adaptation following cancer. Links between protective buffering and intimacy have not been examined in the context of daily life, and links with FCR have not been studied. We hypothesized that protective buffering is associated with decreased intimacy and increased FCR at a daily, within-person level. METHODS Sixty-nine early-stage breast cancer (BC) survivors and their spouses completed electronic diaries for 21 consecutive days at the end of adjuvant treatment. Patients and spouses reported on daily protective buffering, intimacy, and FCR. Dyadic multilevel path modeling was used to estimate within-person effects. Patient and spouse protective buffering on one's own as well as one's partner's same-day intimacy and FCR were examined, controlling for previous levels of intimacy and FCR. RESULTS Protective buffering was associated with decreased intimacy and increased FCR for the individual reporting buffering that same day. Patient and spouse protective buffering was also linked to decreased intimacy for her/his partner that same day. Moreover, patient protective buffering predicted increased spouse FCR that same day. CONCLUSIONS Findings supported a daily, within-person link between buffering, intimacy, and FCR, suggesting open disclosure of cancer-related concerns may be a relevant target for interventions for adaptation to BC.
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Affiliation(s)
- Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Scott D Siegel
- Psychosocial Oncology, Helen F. Graham Cancer Center & Research Institute, Newark, Delaware, USA
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Otto AK, Soriano EC, Siegel SD, LoSavio ST, Laurenceau JP. Assessing the relationship between fear of cancer recurrence and health care utilization in early-stage breast cancer survivors. J Cancer Surviv 2018; 12:775-785. [PMID: 30341560 DOI: 10.1007/s11764-018-0714-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/03/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of this study was to determine whether fear of cancer recurrence (FCR) is associated with greater health care utilization (HCU) in early-stage breast cancer survivors. METHODS Three hundred early-stage breast cancer survivors diagnosed within the past 7 years reported on FCR as well as calls and visits to oncology providers and primary care providers during the preceding 3 months. Participants also reported on use of mental health services and psychotropic medications since diagnosis. Structural equation modeling was used to create a latent FCR factor and evaluate this factor as a predictor of various HCU outcomes controlling for age at diagnosis, years since diagnosis, generalized anxiety, objective risk of recurrence, and number of comorbidities. RESULTS FCR predicted more visits to both oncology providers (RR = 1.53, p = .002) and primary care providers (RR = 1.31, p = .013), as well as more phone calls to oncology providers (RR = 2.08, p = .007). FCR was not a significant predictor of phone calls to primary care providers (RR = 1.39, p = .054), utilization of mental health treatment (OR = 1.27, p = .362), or use of psychotropic medications (OR = 1.37, p = .178). CONCLUSIONS FCR was associated with increases in some types of HCU, which may reflect excessive medical reassurance-seeking and lead to unnecessary medical costs. IMPLICATIONS FOR CANCER SURVIVORS FCR is a serious concern that warrants greater attention to reduce distress-related health care utilization. Utilization of mental health services to address FCR may represent higher-value health care.
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Affiliation(s)
- Amy K Otto
- Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA.
| | - Emily C Soriano
- Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA
| | - Scott D Siegel
- Helen F. Graham Cancer Center and Research Institute, 4701 Ogletown Stanton Rd, Newark, DE, 19713, USA
| | - Stefanie T LoSavio
- Duke University Medical Center, 1121 W. Chapel Hill St., Ste. 201, Durham, NC, 27701, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19716-2577, USA.
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Soriano EC, Pasipanodya EC, LoSavio ST, Otto AK, Perndorfer C, Siegel SD, Laurenceau JP. Social constraints and fear of recurrence in couples coping with early stage breast cancer. Health Psychol 2018; 37:874-884. [PMID: 30138023 PMCID: PMC6110096 DOI: 10.1037/hea0000649] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is a top concern of breast cancer (BC) survivors and their spouses. FCR often occurs within an interpersonal context, yet there has been little research on relationship processes that may influence FCR in patients and spouses. It was hypothesized that the inhibition of disclosure of cancer-related concerns, thoughts, and feelings because of perceived partner disinterest or avoidance (termed social constraints) would predict greater FCR in BC patients and their spouses both globally and in the context of everyday life. METHOD Two studies, 1 cross-sectional (N = 46 couples) and 1 daily diary (21 days; N = 72 couples), were conducted to examine the between-person and within-person associations between social constraints and FCR in early stage BC patients and their spouses. Assessments were conducted about 6 months after BC surgery. RESULTS Global social constraints predicted greater global FCR in patients and spouses at the cross-sectional level, controlling for anxiety symptoms, relationship quality, and patient age, physical impairment, and BC stage. At the within-person level, results indicated that on days when more social constraints were reported, both partners were more likely to report greater FCR, controlling for momentary negative affect and relationship quality. CONCLUSIONS This study is the first to examine the within-person association between social constraints and FCR. These findings suggest relationship processes, particularly inhibition of disclosure, can uniquely influence the experience of FCR for both BC patients and their spouses, pointing to an important consideration for future research and possible intervention development. (PsycINFO Database Record
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Affiliation(s)
- Emily C Soriano
- Department of Psychological and Brain Sciences, University of Delaware
| | | | - Stefanie T LoSavio
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
| | - Amy K Otto
- Department of Psychological and Brain Sciences, University of Delaware
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Soriano EC, Perndorfer C, Otto AK, Siegel SD, Laurenceau JP. Does sharing good news buffer fear of bad news? A daily diary study of fear of cancer recurrence in couples approaching the first mammogram post-diagnosis. Psychooncology 2018; 27:2581-2586. [DOI: 10.1002/pon.4813] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/26/2018] [Accepted: 06/07/2018] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Amy K. Otto
- University of Delaware; Newark DE United States
| | - Scott D. Siegel
- Helen F. Graham Cancer Center and Research Institute; Newark DE United States
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Soriano EC, Otto AK, Siegel SD, Laurenceau JP. Partner social constraints and early-stage breast cancer: Longitudinal associations with psychosexual adjustment. J Fam Psychol 2017; 31:574-583. [PMID: 28206777 PMCID: PMC5555802 DOI: 10.1037/fam0000302] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Women with breast cancer (BC) who perceive social constraints on their disclosure of cancer-related concerns are more likely to experience distress and have difficulty adjusting after diagnosis. Much of the existing research on psychosocial adjustment is cross-sectional in nature and an important area of concern that has received little attention is psychosexual adjustment to cancer surgery and treatment. This study examined whether perceived partner social constraints were associated with psychosexual adjustment over time in 108 BC survivors. Early-stage BC patients completed measures of partner social constraints, psychosexual adjustment, and relationship dissatisfaction approximately 1 month, 8 months, and 4 years after initial surgery. Latent growth curve modeling revealed partner social constraints to be a significant time-varying, within-person predictor of psychosexual adjustment at each time point after controlling for relationship dissatisfaction. BC surgery type, reconstructive surgery, cancer stage, chemotherapy, or antihormonal adjuvant treatment did not moderate this effect. Findings point to a long-term link between social constraints and psychosexual outcomes in BC patients and clinical implications for women coping with BC. (PsycINFO Database Record
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Affiliation(s)
- Emily C Soriano
- Department of Psychological and Brain Sciences, University of Delaware
| | - Amy K Otto
- Department of Psychological and Brain Sciences, University of Delaware
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Dwyer LA, Bolger N, Laurenceau JP, Patrick H, Oh AY, Nebeling LC, Hennessy E. Autonomous Motivation and Fruit/Vegetable Intake in Parent-Adolescent Dyads. Am J Prev Med 2017; 52:863-871. [PMID: 28526363 PMCID: PMC5512865 DOI: 10.1016/j.amepre.2017.01.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/28/2016] [Accepted: 01/05/2017] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Autonomous motivation (motivation to engage in a behavior because of personal choice, interest, or value) is often associated with health behaviors. The present study contributes to research on motivation and eating behaviors by examining (1) how autonomous motivation is correlated within parent-adolescent dyads and (2) whether parent- and adolescent-reported autonomous motivation predicts the parent-adolescent correlation in fruit and vegetable (FV) intake frequency. METHODS Data were drawn from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, a cross-sectional U.S. survey of parent-adolescent dyads led by the National Cancer Institute and fielded between April and October 2014. In 2016, data were analyzed from dyads who had responses on a six-item self-report measure of daily frequency of FV consumption and a two-item self-report measure of autonomous motivation for consuming FVs. RESULTS Parents' and adolescents' reports of autonomous motivation and FV intake frequency were positively correlated. Both parents' and adolescents' autonomous motivation predicted higher levels of their own FV intake frequency and that of their dyad partner (p-values ≤0.001). These effects of autonomous motivation explained 22.6% of the parent-adolescent correlation in FV intake frequency. Actor effects (one's motivation predicting their own FV intake frequency) were stronger than partner effects (one's motivation predicting their partner's FV intake frequency). CONCLUSIONS Parent-adolescent similarity in autonomous motivation for healthy eating may contribute to similarity in eating behaviors. Future research should further examine how individual-level health behavior correlates influence health behaviors within dyads.
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Affiliation(s)
- Laura A Dwyer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland; Cape Fox Facilities Services, Manassas, Virginia.
| | - Niall Bolger
- Department of Psychology, Columbia University, New York, New York
| | | | - Heather Patrick
- Clinical Innovations, Applied Behavior Change Science, Envolve PeopleCare, Bethesda, Maryland
| | - April Y Oh
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Linda C Nebeling
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Erin Hennessy
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, Maryland
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Brown ED, Garnett ML, Anderson KE, Laurenceau JP. Can the Arts Get Under the Skin? Arts and Cortisol for Economically Disadvantaged Children. Child Dev 2016; 88:1368-1381. [PMID: 27921313 DOI: 10.1111/cdev.12652] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Fowers BJ, Laurenceau JP, Penfield RD, Cohen LM, Lang SF, Owenz MB, Pasipandoya E. Enhancing relationship quality measurement: The development of the Relationship Flourishing Scale. J Fam Psychol 2016; 30:997-1007. [PMID: 27918187 DOI: 10.1037/fam0000263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Relationship quality is the most frequently assessed construct in the intimate relationships literature. Dozens of assessment instruments exist, but the vast majority conceptualize relationship quality in terms of satisfaction (or a similar construct), which focuses on the hedonic (pleasure or happiness) dimension of the relationship. Some scholars question whether the richness and depth of adult intimate relationships can be captured by satisfaction ratings and suggest focusing on a complementary eudaimonic (human flourishing) dimension of the relationship. This study evaluates the development of the Relationship Flourishing Scale, a 12-item measure of eudaimonic relationship quality that assesses meaning, personal growth, relational giving, and goal sharing. The study supports the construct validity of the Relationship Flourishing Scale, including its content, concurrent, convergent, discriminant, and incremental validity. Its incremental validity and independence suggest that it provides information about deeper and richer aspects of relationship quality than do current hedonic relationship quality measures. (PsycINFO Database Record
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Affiliation(s)
- Blaine J Fowers
- Department of Educational and Psychological Studies, University of Miami
| | | | - Randall D Penfield
- Educational Research Methodology Department, University of North Carolina at Greensboro
| | - Laura M Cohen
- Department of Educational and Psychological Studies, University of Miami
| | - Samantha F Lang
- Department of Educational and Psychological Studies, University of Miami
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Otto AK, Szczesny EC, Soriano EC, Laurenceau JP, Siegel SD. Effects of a randomized gratitude intervention on death-related fear of recurrence in breast cancer survivors. Health Psychol 2016; 35:1320-1328. [PMID: 27513475 DOI: 10.1037/hea0000400] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Among the most prevalent and distressing concerns endorsed by breast cancer survivors is fear of cancer recurrence (FOR), and one of the most salient facets is the worry that a recurrence of cancer could cause one's death. The primary goal of the present study was to test the effects of a brief, low-cost gratitude intervention on overall FOR and death-related FOR, positing pursuit of meaningful goals as a theoretically driven putative mediator. To replicate published tests of similar gratitude-eliciting interventions, positive affect (PA) was also considered as an outcome. METHOD Sixty-seven women with early stage breast cancer were randomly assigned to either a 6-week online gratitude intervention or a 6-week online control condition. Outcomes were assessed at pre- and posttreatment, as well as 1 month and 3 months after the end of treatment. The mediator, meaningful goal pursuit, was measured via assessments over the 6-week intervention period. RESULTS Results revealed that patients in the gratitude intervention experienced a significant decrease in death-related FOR compared to the control condition. Moreover, this effect was significantly mediated by meaningful goal pursuit (and not by PA). The gratitude intervention was also found to prevent declines in PA observed in the control condition. CONCLUSIONS Overall, findings support the notion that a brief gratitude intervention can promote well-being and psychological adaptation to cancer by stimulating the pursuit of meaningful goals and subsequently reducing death-related FOR. (PsycINFO Database Record
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Affiliation(s)
- Amy K Otto
- Department of Psychological & Brain Sciences
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Abstract
Women (N = 138) with histories of illicit drug use were recruited into an electronic diary study that used Android smartphones for data collection. The diary was to be completed each day for 12 weeks using an "app" created in HTML5 and accessed over the Internet via smartphone. Data collection included information on sexual behaviors with up to 10 partners per day and contextual factors surrounding sexual behavior such as drug use before/after, type of sexual behavior (oral, vaginal, anal), and other activities such as using condoms for vaginal and anal intercourse and use of sexual lubricants. The sample was predominantly African American (58 %); 20 % Latina, 20 % White and 2 % reported as Other. Most women reported either less than a high school education (33 %) or having a high school diploma (33 %). The mean age was 39 years (SD = 11.78). Anal intercourse occurred on days when women also reported using illicit drugs, specifically methamphetamine and cocaine. Anal intercourse was not an isolated sexual activity, but took place on days when vaginal intercourse and giving and receiving oral sex also occurred along with illicit drug use. Anal intercourse also occurred on days when women reported they wanted sex. HIV prevention interventions must address the risks of anal intercourse for women, taking into account concurrent drug use and sexual pleasure that may reduce individual harm-reduction behaviors.
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Affiliation(s)
- Grace L Reynolds
- Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840, USA.
| | - Dennis G Fisher
- Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840, USA
| | | | - J Dennis Fortenberry
- Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Ready CB, Hayes AM, Yasinski CW, Webb C, Gallop R, Deblinger E, Laurenceau JP. Overgeneralized Beliefs, Accommodation, and Treatment Outcome in Youth Receiving Trauma-Focused Cognitive Behavioral Therapy for Childhood Trauma. Behav Ther 2015; 46:671-88. [PMID: 26459847 PMCID: PMC4607930 DOI: 10.1016/j.beth.2015.03.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 03/14/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
Inhibition of fear generalization with new learning is an important process in treatments for anxiety disorders. Generalization of maladaptive cognitions related to traumatic experiences (overgeneralized beliefs) have been demonstrated to be associated with posttraumatic stress disorder (PTSD) in adult populations, whereas more balanced, accommodated beliefs are associated with symptom improvement. It is not yet clear whether (a) overgeneralization and accommodation are associated with PTSD treatment outcome in youth, or (b whether accommodated beliefs can interact with or inhibit cognitive overgeneralization, as has been demonstrated in research on behavior-based fear generalization. The current study examined the relationships between overgeneralized and accommodated beliefs, child age, and symptom reduction in a sample of 81 youth (age 7-17 years), who received Trauma-Focused Cognitive Behavioral Therapy. Overgeneralized and accommodated beliefs expressed during the exposure phase of treatment were coded in audio-recorded therapy sessions. Overgeneralization predicted (a) higher internalizing symptom scores at posttreatment, particularly for younger children, and less improvement over treatment, and (b) higher externalizing scores at 1-year follow-up and steeper symptom increases over this period. In contrast, accommodation was associated with (a) lower posttreatment internalizing symptoms and greater improvement over treatment, and (b) lower externalizing scores at 1-year follow-up, particularly for younger children. High levels of accommodation moderated the relationship between overgeneralization and worse symptom outcomes, except when predicting the slope of internalizing scores over treatment, and age did not moderate these effects. There were no significant predictors of child-reported PTSD-specific symptoms, although PTSD symptoms did decrease significantly over the course of treatment and maintain 1year after treatment.
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Affiliation(s)
| | | | | | - Charles Webb
- State of Delaware Prevention and Behavioral Health Services
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Webster GD, Laurenceau JP, Smith CV, Mahaffey AL, Bryan AD, Brunell AB. An investment model of sociosexuality, relationship satisfaction, and commitment: Evidence from dating, engaged, and newlywed couples. Journal of Research in Personality 2015. [DOI: 10.1016/j.jrp.2015.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Otto AK, Laurenceau JP, Siegel SD, Belcher AJ. Capitalizing on everyday positive events uniquely predicts daily intimacy and well-being in couples coping with breast cancer. J Fam Psychol 2015; 29:69-79. [PMID: 25528074 PMCID: PMC5407905 DOI: 10.1037/fam0000042] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Capitalization is the relational process of savoring positive life events by sharing them with responsive relationship partners. The purpose of the present study was to use dyadic intensive longitudinal methods to examine novel hypotheses regarding links between capitalization processes and daily intimacy and well-being in women with breast cancer and their intimate partners. Although couples coping with cancer often experience an increase in negative daily life events, we hypothesized that it would be important for them to share and capitalize on positive events in addition to sharing negative events. Female patients with early stage breast cancer and their intimate partners (99 couples) completed electronic daily diaries for 7 to 10 consecutive days tapping everyday processes of sharing negative and positive events with each other. Dyadic multilevel process modeling revealed that on days when capitalization attempts (i.e., sharing the best event of the day) occurred, daily feelings of intimacy in the sharer were higher for both patients and partners. Moreover, greater perceived partner responsiveness to capitalization attempts was associated with increases in the sharer's daily feelings of intimacy and decreases in the sharer's daily negative affect. When the patient's partner was the sharer, perceived partner responsiveness also was associated with increased daily positive affect. More important, all effects of capitalization were observed above and beyond the effects of event positivity and sharing negative events (i.e., social support attempts). Findings suggest that, even in the midst of significant life adversity, sharing daily good news with intimate partners enhances relationship well-being independently of sharing bad news.
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Affiliation(s)
- Amy K Otto
- Department of Psychological and Brain Sciences, University of Delaware
| | | | | | - Amber J Belcher
- Department of Psychological and Brain Sciences, University of Delaware
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Jongerling J, Laurenceau JP, Hamaker EL. A Multilevel AR(1) Model: Allowing for Inter-Individual Differences in Trait-Scores, Inertia, and Innovation Variance. Multivariate Behav Res 2015; 50:334-349. [PMID: 26610033 DOI: 10.1080/00273171.2014.1003772] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In this article we consider a multilevel first-order autoregressive [AR(1)] model with random intercepts, random autoregression, and random innovation variance (i.e., the level 1 residual variance). Including random innovation variance is an important extension of the multilevel AR(1) model for two reasons. First, between-person differences in innovation variance are important from a substantive point of view, in that they capture differences in sensitivity and/or exposure to unmeasured internal and external factors that influence the process. Second, using simulation methods we show that modeling the innovation variance as fixed across individuals, when it should be modeled as a random effect, leads to biased parameter estimates. Additionally, we use simulation methods to compare maximum likelihood estimation to Bayesian estimation of the multilevel AR(1) model and investigate the trade-off between the number of individuals and the number of time points. We provide an empirical illustration by applying the extended multilevel AR(1) model to daily positive affect ratings from 89 married women over the course of 42 consecutive days.
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Affiliation(s)
| | | | - Ellen L Hamaker
- a Department of Methodology and Statistics , Utrecht University
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40
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Bernard K, Peloso E, Laurenceau JP, Zhang Z, Dozier M. Examining change in cortisol patterns during the 10-week transition to a new child-care setting. Child Dev 2014; 86:456-71. [PMID: 25283439 DOI: 10.1111/cdev.12304] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The transition to out-of-home child care brings a number of challenges for children, including complex peer interactions and extended separations from parents. Children often show a midmorning to afternoon rise in cortisol on child-care days, compared to the typical diurnal decline seen at home. Changes in cortisol were examined in a wide age range of children (N = 168; 1.2 months to 8 years, M = 3.27 years) during the 10-week transition to a new child-care setting. Structural equation modeling using latent change scores showed that children experienced an increase in the cortisol rise at child care across the 10-week transition. Furthermore, child age moderated the difference between home- and child-care cortisol patterns. Findings are placed in a developmental context, and potential implications and future directions are discussed.
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Gamarel KE, Reisner SL, Laurenceau JP, Nemoto T, Operario D. Gender minority stress, mental health, and relationship quality: a dyadic investigation of transgender women and their cisgender male partners. J Fam Psychol 2014; 28:437-47. [PMID: 24932942 PMCID: PMC4122619 DOI: 10.1037/a0037171] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Research has demonstrated associations between experiences of discrimination, relationship quality, and mental health. However, critical questions remain unanswered with regard to how stigma enacted and experienced at the dyadic-level influences relationship quality and mental health for transgender women and their cisgender (nontransgender) male partners. The present study sought to examine how experiences of transgender-related discrimination (i.e., unfair treatment, harassment) and relationship stigma (i.e., the real or anticipated fear of rejection based on one's romantic affiliation) were associated with both partners relationship quality and mental health. Couples (n = 191) were recruited to participate in cross-sectional survey. Dyadic analyses using actor-partner interdependence models were conducted to examine the influence of minority stressors on clinically significant depressive distress and relationship quality. For both partners, financial hardship, discrimination, and relationship stigma were associated with an increased odds of depressive distress. For both partners, financial hardship was associated with lower relationship quality. Among transgender women, their own and their partner's higher relationship stigma scores were associated with lower relationship quality; however, among male partners, only their partner's greater relationship stigma scores were associated with lower relationship quality. Findings provide preliminary support for dyadic crossover effects of relationship stigma on the health of partners. Findings illustrate the importance of minority stress and dyadic stress frameworks in understanding and intervening upon mental health disparities among transgender women and their male partners. Couples-based interventions and treatment approaches to help transgender women and their male partners cope with minority stressors are warranted to improve the health and well-being of both partners.
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Affiliation(s)
| | - Sari L. Reisner
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- The Fenway Institute, Fenway Health, Boston, MA
| | | | | | - Don Operario
- Brown University School of Medicine, Providence, RI
- Brown University School of Public Health, Providence, RI
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Badr H, Pasipanodya EC, Laurenceau JP. An electronic diary study of the effects of patient avoidance and partner social constraints on patient momentary affect in metastatic breast cancer. Ann Behav Med 2014; 45:192-202. [PMID: 23150234 DOI: 10.1007/s12160-012-9436-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Metastatic breast cancer patients experience significance distress. Although talking with close others about cancer-related concerns may help to alleviate distress, patients often avoid such discussions, and their partners can engage in social constraints that may limit subsequent patient disclosures and exacerbate distress. PURPOSE We examined how partner constraints unfold, how they influence patient affect, and whether they exacerbate patient avoidance of cancer-related disclosures. METHODS Fifty-four patients and 48 of their partners completed electronic diary assessments for 14 days. RESULTS Partners' social constraints carried over from one day to the next, but patients' avoidance of discussing cancer-related concerns did not. When partners engaged in more social constraints one day, patients reported greater negative affect the following day (p < 0.05). CONCLUSION Findings suggest a temporal link between partner constraints and patient momentary affect. Helping partners to become aware of their constraining behaviors and teaching them skills to overcome this may facilitate patient adjustment to metastatic breast cancer.
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Affiliation(s)
- Hoda Badr
- Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY 10029, USA.
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Webb C, Hayes A, Grasso D, Laurenceau JP, Deblinger E. Trauma-Focused Cognitive Behavioral Therapy for Youth: Effectiveness in a Community Setting. Psychol Trauma 2014; 6:555-562. [PMID: 25422717 DOI: 10.1037/a0037364] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The current investigation examined the effectiveness of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in treating child traumatic stress when implemented in community settings on a state-wide level. METHOD Seventy-two youths (ages 7-16 years) with a history of documented trauma (sexual or physical abuse, traumatic loss, domestic or community violence) and symptoms of Posttraumatic Stress Disorder (PTSD) received an average of 10 sessions delivered in a state-contracted mental health agency. PTSD symptoms and internalizing and externalizing behavior problems were assessed at pre-treatment and then at 3-, 6-, 9-, and 12-months after intake. RESULTS Piecewise hierarchical linear modeling revealed that symptoms of PTSD, as well as internalizing and externalizing problems, decreased significantly over the six months after intake (pretreatment, 3-month, 6-month assessments), and these gains were maintained over the next 6 months (6, 9, and 12 month assessments). Symptoms of externalizing symptoms increased somewhat during the follow-up period, but this change was not statistically significant. CONCLUSIONS These findings suggest that TF-CBT can be implemented effectively in community settings. Treatment outcomes were similar to those reported in efficacy trials of TF-CBT delivered in specialty clinic settings. Improvements in PTSD symptoms and internalizing and externalizing problems were maintained up to one year after treatment began, although the changes in externalizing symptoms were the least stable.
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Affiliation(s)
- Charles Webb
- Delaware Division of Prevention and Behavioral Health Services
| | - Adele Hayes
- Department of Psychology at the University of Delaware
| | - Damion Grasso
- Department of Psychiatry at the University of Connecticut Health Center
| | | | - Esther Deblinger
- School of Osteopathic Medicine at the University of Medicine and Dentistry at New Jersey
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Cummings JA, Hayes AM, Cohen LH, Laurenceau JP, Saint DS, Gricol K. Interpersonal Competence and Daily Stress Generation in Individuals with Avoidant Personality Disorder Symptoms. Journal of Social and Clinical Psychology 2013. [DOI: 10.1521/jscp.2013.32.2.135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Grosse Holtforth M, Hayes AM, Sutter M, Wilm K, Schmied E, Laurenceau JP, Caspar F. Fostering cognitive-emotional processing in the treatment of depression: a preliminary investigation in exposure-based cognitive therapy. Psychother Psychosom 2012; 81:259-60. [PMID: 22678232 DOI: 10.1159/000336813] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 01/23/2012] [Indexed: 11/19/2022]
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Kobak R, Herres J, Gaskins C, Laurenceau JP. Teacher-student interactions and attachment states of mind as predictors of early romantic involvement and risky sexual behaviors. Attach Hum Dev 2012; 14:289-303. [PMID: 22537525 DOI: 10.1080/14616734.2012.672282] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Adolescents' capacities to negotiate sexual behavior in romantic relationships have important implications for their reproductive and health outcomes. This study examined adolescents' interactions with teachers and attachment states of mind as predictors of their romantic involvement and risky sexual behavior in an economically disadvantaged sample. Negative interactions with teachers predicted increased sexual risk-taking behaviors and females' early romantic involvement. Preoccupied states of mind increased risk for early romantic involvement and the likelihood that females would engage in risky sexual behavior. The findings demonstrate how adolescents' school experiences contribute to adaptation in romantic relationships in mid to late adolescence above and beyond representations of parent-child attachment.
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Affiliation(s)
- Roger Kobak
- Department of Psychology, University of Delaware, Newark, USA.
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47
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Chen FF, Hayes A, Carver CS, Laurenceau JP, Zhang Z. Modeling General and Specific Variance in Multifaceted Constructs: A Comparison of the Bifactor Model to Other Approaches. J Pers 2012; 80:219-51. [PMID: 22092195 DOI: 10.1111/j.1467-6494.2011.00739.x] [Citation(s) in RCA: 275] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Support from a partner can play a key role in a woman's emotional adjustment to breast cancer. However, little is known about the influence of partner behaviours on a woman's sexual adjustment. This study examined the prospective relationship between baseline levels of several types of perceived partner support (instrumental, informational, emotional and negative) and psychosexual adjustment (sexual functioning and relationship satisfaction) over the course of 12 months post-surgery in a sample of 130 women with breast cancer. Results indicated that perceptions of greater emotional and informational support from the partner at baseline were associated with less sexual difficulties among breast cancer patients concurrently and 6 months post-surgery. Baseline perceptions of greater emotional and instrumental support from a partner were associated with greater relationship satisfaction at all time points. Perceptions of informational support at baseline were related to greater concurrent relationship satisfaction. Baseline perceptions of negative partner support were related to less relationship satisfaction, but only concurrently. These findings suggest that the perception of a partner's provision of emotional, instrumental and informational support may each play a role in facilitating sexual adjustment and relationship satisfaction.
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Belcher AJ, Laurenceau JP, Graber EC, Cohen LH, Dasch KB, Siegel SD. Daily support in couples coping with early stage breast cancer: maintaining intimacy during adversity. Health Psychol 2011; 26:661-7. [PMID: 21823795 DOI: 10.1037/a0028655] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Recent work has identified intimacy as a potentially important determinant of psychological adjustment in couples coping with cancer. Little work has examined specific social support processes within the context of the everyday life of couples' cancer experience. Specifically, we examined the links between breast cancer patient reports of receiving support from one's spouse/partner (support receipt) and spouse reports of providing support to the patient (support provision) with daily intimacy outcomes. We hypothesized that both patient and spouse would benefit from support receipt and support provision. METHOD Forty-five women with early stage breast cancer and their spouses independently completed an Internet-based electronic diary assessing support receipt, support provision, and relationship intimacy for seven consecutive evenings shortly after surgery. Study outcomes consisted of daily relationship intimacy reported by each partner. RESULTS As hypothesized, when controlling for patient report of support receipt, spouse report of support provision was uniquely associated with a significant additional increase in feelings of relationship intimacy for patients. Moreover, the independent effects of support receipt and support provision were also found to be beneficial for nonpatient spouses' daily feelings of intimacy. CONCLUSION Findings highlight the use of dyadic diary methods and corresponding modeling to uncover the unique benefits of support provision that may sometimes occur outside the awareness of the recipient. Results are discussed in terms of conceptualizing the cancer experience in a shared interpersonal context, whereby patients and their spouses can both benefit from support as they adjust to cancer together.
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Affiliation(s)
- Amber J Belcher
- Department of Psychology, University of Delaware, Newark, DE 19716, USA
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Graber EC, Laurenceau JP, Carver CS. Integrating the dynamics of personality and close relationship processes: methodological and data analytic implications. J Pers 2011; 79:1403-39. [PMID: 21299559 DOI: 10.1111/j.1467-6494.2011.00725.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A common theme that has emerged from classic and contemporary theoretical work in both the fields of personality and relationship science is a focus on process. Current process-focused theories bearing on personality invoke a view of the individual in ongoing action and interaction with the environment, reflecting a flow of experience rather than a static depiction. To understand the processes by which personality interacts with the social environment (particularly dyads), investigations must capture individuals interacting in multiple interpersonal situations, which likely necessitates complex study designs and corresponding data analytic strategies. Using an illustrative simulated data set, we focus on diary methods and corresponding individual and dyadic multilevel models to capture person-situation interaction within the context of processes in daily close relationship life. Finally, we consider future directions that conceptualize personality and close relationship processes from a dynamical systems theoretical and methodological perspective.
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Affiliation(s)
- Elana C Graber
- University of Delaware, Psychology, Newark, DE 19711, USA
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