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Shahrour L, Martinez J, Chicaiza A, Omar R, Bovbjerg K, Stanton AL, Valdimarsdottir H, Yanez B, Munshi P, Rowley SD, Rini C, Graves KD. Greater Social Isolation and Social Constraints Prior to Hematopoietic Stem Cell Transplant Are Associated with Greater Anxiety and Depressive Symptoms. Int J Behav Med 2024; 31:341-351. [PMID: 38017317 DOI: 10.1007/s12529-023-10232-8] [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: 10/04/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Hematopoietic stem cell transplantation (hereafter "HCT") is a physically and psychologically difficult treatment for patients with hematological cancers. This study examined relationships among patients' reports of pre-transplant social isolation, social constraints, and psychological distress. METHOD We used baseline data from a multisite randomized controlled trial evaluating the effects of expressive helping writing to reduce physical and emotional symptoms in HCT patients. We collected data prior to randomization and before either allogenic or autologous HCT using validated scales to assess social constraints, social isolation, anxiety, and depressive symptoms. We analyzed data using bivariate analysis and multivariate linear regression. We also explored whether social isolation mediated the effect of social constraints on both of our outcomes: anxiety and depressive symptoms. RESULTS Among 259 adults recruited prior to transplant, 43.6% were women (mean age = 57.42 years, SD = 12.34 years). In multivariate analysis controlling for relevant covariates, both social isolation (β = 0.24, p < 0.001) and social constraints (β = 0.28, p < 0.001) were associated with anxiety. When both social constraints and social isolation were in the model, only greater social isolation (β = 0.79, p < 0.001) was associated with depressive symptoms. Social isolation fully mediated the association between social constraints and anxiety and depressive symptoms. CONCLUSION For patients awaiting either allogenic or autologous HCT, the negative association between social constraints and anxiety and depressive symptoms may be related, in part, to the mechanism of perceived social isolation. Interventions prior to and during HCT are needed to support patients' psychological health and sense of social connectedness.
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Affiliation(s)
| | | | - Anthony Chicaiza
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| | - Rahma Omar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katrin Bovbjerg
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Heiddis Valdimarsdottir
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Betina Yanez
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Pashna Munshi
- MedStar Georgetown University Hospital, Washington, D.C, USA
| | - Scott D Rowley
- John Theurer Cancer Center, Hackensack Meridian Health, Hackensack, NJ, USA
| | - Christine Rini
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Kristi D Graves
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA.
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Gu Z, Li M, Liu L, Ban Y, Wu H. The moderating effect of self-efficacy between social constraints, social isolation, family environment, and depressive symptoms among breast cancer patients in China: a cross-sectional study. Support Care Cancer 2023; 31:594. [PMID: 37768382 DOI: 10.1007/s00520-023-08063-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 11/08/2022] [Accepted: 09/22/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND For female breast cancer patients, the psychological status after surgery, especially the social and family psychological-related factors, deserves more attention. This study analyzed the influence of social constraints, social support, social isolation, family conflict, and family emotion expression on depression. At the same time, this study conducted the relationship between the variables and the mechanism of action. METHODS We conducted a cross-sectional study and 522 breast cancer patients finished questionnaires consisting of Self-Rating Depression Scale (SDS), General Self-Efficacy Scale (GSES), Multi-Dimensional Scale of Perceived Social Support (MSPSS), Social Constraints Scale-5 (SCS-5), Family Environment Scale (FES), and Lubben Social Network Scale (LSNS-6). Multivariable logical regression was used to explore influencing factors. Pearson's correlation, hierarchical regression, and simple slope analysis were conducted to verify the role of self-efficacy. RESULTS 71.6% of patients had depressive symptoms. Family contradiction (OR = 10.086), social constraints (OR = 2.522), social isolation (OR = 2.507), and high blood glucose (OR = 2.156) were risk factors of depressive symptoms. Family emotional expression (OR = 0.480), family intimacy (OR = 0.235), and self-efficacy (OR = 0.246) were protective factors against depressive symptoms. The interactive items interpretation quantity were as follows: Contradiction*Self-efficacy (ΔR2 = 2.3%, P < 0.001), Emotional expression*Self-efficacy (ΔR2 = 2.6%, P < 0.001), Intimacy*Self-efficacy (ΔR2 = 1.0%, P = 0.018), Social constraints*Self-efficacy (ΔR2 = 1.0%, P = 0.008), Social networks*Self-efficacy (ΔR2 = 1.0%, P = 0.010), Blood Glucose*Self-efficacy (ΔR2 = 0.6%, P = 0.023). The influence of independent variables on depressive symptoms was gradually decreased in the low, mean, and high groups of self-efficacy. CONCLUSION Postoperative Chinese breast cancer survivors reported higher depressive symptoms. Social, family, and physiological factors could affect depressive symptoms, in which self-factor played moderator roles.
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Affiliation(s)
- ZhiHui Gu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 PuHe Road, Shenyang North New Area, Shenyang, 110122, China
| | - MengYao Li
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 PuHe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 PuHe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Yue Ban
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 PuHe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Hui Wu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 PuHe Road, Shenyang North New Area, Shenyang, 110122, China.
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Cui C, Wang L, Wang X. Profiles of social constraints and associated factors among breast cancer patients: a latent profile analysis. BMC Psychiatry 2022; 22:750. [PMID: 36451108 DOI: 10.1186/s12888-022-04407-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/18/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The present study aimed to identify profiles of social constraints among Chinese breast cancer patients and to explore the variables associated with these patterns. METHODS The study recruited 133 Chinese breast cancer patients in Liaoning Province, China, between June 2021 and February 2022. The questionnaire package included the Social Constraints Scale (SCS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the Social Impact Scale (SIS). The methods of statistical analysis used included latent profile analysis (LPA) and multinomial logistic regression. RESULTS Three latent patterns of social constraints were found: class 1-the low social constraints group (51.9%), class 2-the moderate social constraints group (35.3%), and class 3-the high social constraints group (12.8%). Patients with high social support were more likely to report a low level of social constraint, while patients with a greater fear of progression were more likely to report a moderate or high level of social constraints. Significant differences existed among the latent classes identified by reference to social constraint in terms of education. CONCLUSION These results suggest that breast cancer patients' perceptions of social constraints vary and exhibit individual differences. Health care providers should take into account patients' fear of progression as well as their social support when developing interventions for patients with a high level of social constraints.
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Cui C, Wang L, Wang X. Health-related quality of life and social constraints among Chinese breast cancer patients: a cross-sectional study. Health Qual Life Outcomes 2021; 19:238. [PMID: 34641883 PMCID: PMC8507183 DOI: 10.1186/s12955-021-01871-0] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/26/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Most research studying social constraints has been performed among Caucasian or Asian American breast cancer (BC) patients, but few studies have evaluated social constraint levels and explored the effect of social constraints on the integrative health-related quality of life (HRQOL) of Chinese BC patients. Therefore, our study aimed to examine the association of social constraints with HRQOL among Chinese women with BC. METHODS This was a cross-sectional study of 136 Chinese women diagnosed with BC in Liaoning Province, China, from December 2020 to May 2021. Questionnaire information contained HRQOL, social constraints, social support, social stigma, and sociodemographic and clinical characteristics. Multiple linear regression was used to analyse the association of psychological factors with HRQOL. RESULTS The mean score of FACT-B was 96.05 (SD = 18.70). After controlling for potential confounders, social constraints (Beta = - 0.301, P < 0.001) and social stigma (Beta = - 0.241, P = 0.001) were negatively associated with HRQOL and social support (Beta = 0.330, P < 0.001) was positively associated with HRQOL, which explained 44.3% of the variance in HRQOL. CONCLUSIONS The findings of the current study suggest that Chinese BC patients' HRQOL needs to be enhanced after treatment. Social constraints have a strong association with HRQOL. Intervention strategies focusing on less personal disclosure should be considered to avoid social constraints and improve HRQOL among Chinese patients with BC.
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Affiliation(s)
- Chunying Cui
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People's Republic of China
| | - Xiaoxi Wang
- Medical Basic Experimental Teaching Center, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People's Republic of China.
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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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Brandão T. A systematic review on social constraints in the context of cancer. PSYCHOL HEALTH MED 2020; 26:787-804. [PMID: 32976045 DOI: 10.1080/13548506.2020.1822534] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This review aims to identify, summarise and critically evaluate studies that examined moderators or mediators of the relationship between social constraints and cancer adjustment. A database search was conducted to identify eligible studies published between inception and November 2019. A narrative synthesis of the included studies was conducted. We identified 18 papers, comprising 6933 participants (Mage = 55.70) with different types of cancer (mainly breast cancer). All of the studies used the Social Constraints Scale. Our synthesis shows that the association between social constraints and cancer adjustment is likely to be moderated or mediated by different cognitive (e.g. avoidant coping, intrusive thoughts) and emotional (e.g. emotionality, negative affect) variables. The importance of the moderators and mediators found in this study should be further examined by employing more sophisticated data analytic strategies to assess mediation and by collecting longitudinal data in order to better disentangle the complex associations among variables. However, some important variables were identified as potential targets of interventions for patients facing cancer.
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Affiliation(s)
- Tânia Brandão
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal.,CPUP - Center for Psychology, University of Porto, Porto, Portugal
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Blinka L, Šablatúrová N, Ševčíková A, Husarova D. Social constraints associated with excessive internet use in adolescents: the role of family, school, peers, and neighbourhood. Int J Public Health 2020; 65:1279-1287. [PMID: 32844251 DOI: 10.1007/s00038-020-01462-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Excessive internet use (EIU) has been studied predominantly within the context of individual risk factors. Less attention has been paid to social factors, especially in a fashion complex enough to include the multiple domains of adolescent socialization. This study examined the relationship between EIU and constraints within family, school, peer groups, and neighbourhoods, while controlling for emotional and behavioural difficulties. METHODS This study was based on survey data from the Health Behaviour in School-aged Children study, which was conducted in Slovakia in 2018. The sample of representative adolescents totalled 8400 (mean age: 13.44 years; SDage = 1.33; 50.9% boys). RESULTS Multiple-step linear regression revealed that, after controlling for sociodemographic factors and emotional and behavioural difficulties, peer problems had the least effect, while the constraints related to family and neighbourhood stood out as especially problematic. Combined variables explained 20% variance of EIU. CONCLUSIONS Social constraints proved to be important factors in adolescent EIU. The important role of a problematic neighbourhood is a novel finding and suggests that it should be targeted in prevention.
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Affiliation(s)
- Lukas Blinka
- Faculty of Social Studies, Masaryk University, Joštova 10, 60200, Brno, Czech Republic.
| | - Nika Šablatúrová
- Faculty of Social Studies, Masaryk University, Joštova 10, 60200, Brno, Czech Republic
| | - Anna Ševčíková
- Faculty of Social Studies, Masaryk University, Joštova 10, 60200, Brno, Czech Republic
| | - Daniela Husarova
- Department of Health Psychology and Methodology Research, Faculty of Medicine, P.J. Safarik University in Kosice, Kosice, Slovakia
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Yeung NCY, Wang LJ, Ji L, Lu Q, Lu G. Difficulties in identifying and describing feelings, social constraints, affect, and functional well-being among Chinese breast cancer patients: A mediation model. Eur J Oncol Nurs 2020; 47:101760. [PMID: 32645622 DOI: 10.1016/j.ejon.2020.101760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/06/2020] [Revised: 03/30/2020] [Accepted: 04/04/2020] [Indexed: 12/09/2022]
Abstract
PURPOSE Functional well-being (i.e., individuals' functioning in daily living activities and social roles; FWB) is often an understudied aspect of quality of life among breast cancer patients (BCP). Previous research has suggested that patients' emotional experience is associated with their FWB. However, little is known about how intrapersonal and interpersonal barriers of emotional processing and expression (i.e., social constraints, difficulties in identifying and expressing emotions) associated with FWB among Chinese BCP, plus how positive/negative affect might explain such associations. METHOD Chinese BCP (N = 327) in Weifang, Shandong province, China completed a cross-sectional survey. The Functional Well-Being subscale from the Chinese version of the Functional Assessment of Cancer Therapy-Breast (FACT-B), the Social Constraints Scale, the Difficulty in Identifying Feelings (DIF; 7 items) and the Difficulty in Describing Feelings (DDF; 5 items) subscales from the Toronto Alexithymia Scale and the Positive Affect and Negative Affect Schedule were used as assessment scales. RESULTS Path analyses results supported the proposed mediation model with satisfactory fit indices (χ2(5) = 5.12, p = .40, CFI = 1.00; IFI = 1.00; RMSEA = 0.01). Specifically, difficulty in describing emotions was associated with poorer functional well-being through increased negative affect (β = -0.06, 95%CI = -0.10, -0.03); difficulty in identifying emotions was associated with poorer functional well-being through reduced positive affect (β = -0.04, 95%CI = -0.09, -0.003). Social constraints were associated with poorer functional well-being through both increased negative affect and decreased positive affect (β = -0.16, 95%CI = -0.22, -0.10). After considering the mediators, difficulties in describing emotions still contributed significantly to functional well-being (β = -0.20, 95%CI = -0.31, -0.08). Our results indicated that positive/negative affect could mediate between barriers of emotional processing/expression and FWB. CONCLUSIONS This study was unique in revealing how intrapersonal and interpersonal barriers of emotional processing and expression could be associated with Chinese BCPs' FWB through varied mechanisms. Practitioners should consider strategies to reduce those barriers through interventions.
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Affiliation(s)
- Nelson C Y Yeung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, China
| | - Li-Juan Wang
- Department of Breast Surgery, Weifang People's Hospital, Weifang, China
| | - Lili Ji
- Department of Medical Nursing, Weifang Medical University, China
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, USA.
| | - Guohua Lu
- Department of Medical Nursing, Weifang Medical University, China.
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Chu Q, Wong CCY, Lu Q. Social Constraints and PTSD among Chinese American breast cancer survivors: not all kinds of social support provide relief. J Behav Med 2021; 44:29-37. [PMID: 32519299 DOI: 10.1007/s10865-020-00165-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/03/2020] [Indexed: 10/24/2022]
Abstract
Research has demonstrated the association between social constraints and posttraumatic stress disorder (PTSD) symptoms among breast cancer survivors. Although perceived social support can buffer stress and improve emotional well-being, little is known about which type of social support is most effective in buffering the negative effects of social constraints among cancer survivors. We investigated the moderation of four types of social support (i.e., positive interaction, tangible support, emotional/informational support and affectionate support) on the association between social constraints and PTSD symptoms among Chinese American breast cancer survivors. One hundred and thirty-six Chinese American breast cancer survivors completed questionnaires that assessed social constraints, PTSD symptoms and perceived social support. Results of hierarchical regression analysis indicated that only support of positive interaction exerted a buffering effect, with social constraints associated with greater PTSD severity among survivors with low but not high levels of support of positive interaction. In contrast, high levels of tangible support potentiated the association between social constraints and PTSD symptoms. There were no moderating effects of emotional/informational support and affectionate support. These results demonstrated the roles of different types of social support in moderating the stress imposed by social constraints. Our findings highlight the importance of recognizing the potential cultural sensitivity of ethnic minorities in PTSD intervention and mental health services for cancer patients.
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Chu Q, Wu IHC, Lu Q. Expressive writing intervention for posttraumatic stress disorder among Chinese American breast cancer survivors: the moderating role of social constraints. Qual Life Res 2020; 29:891-899. [PMID: 31900761 DOI: 10.1007/s11136-019-02385-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Accepted: 12/04/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Posttraumatic stress disorder (PTSD) is a significant condition among breast cancer survivors (BCSs). However, few intervention studies for cancer-related PTSD were conducted among Asian cancer survivors. We evaluated a culturally sensitive expressive writing intervention, which combined cognitive reappraisal and emotional disclosure, in reducing PTSD among Chinese American BCSs. We also tested social constraints (defined as social conditions when individuals feel misunderstood or alienated when they desire to disclose their thoughts and feelings) as a moderator. METHODS Chinese American BCSs (n = 136) were randomly assigned to three groups with assigned writing topics for 3 weeks: a self-regulation group, which wrote about the deepest feelings related to cancer in week 1, cognitive reappraisal about stress and coping in week 2, and benefit finding in week 3; an enhanced self-regulation group, with the same instructions, except weeks 1 and 2 were reversed; and a cancer-fact group, which wrote about cancer experiences objectively for 3 weeks. PTSD symptoms were measured at baseline and 1-, 3-, and 6-month follow-ups. Social constraints were measured at baseline. RESULTS Both the self-regulation and enhanced self-regulation groups showed reduced PTSD symptoms compared to the cancer-fact group. For reexperiencing and hyperarousal symptoms, expressive writing was more effective for BCSs who experienced high vs. low levels of social constraints; the opposite was found for avoidance symptoms. CONCLUSION Findings demonstrated the effectiveness of expressive writing intervention in reducing PTSD for this minority population, and that the moderating role of survivors' social network varies among different PTSD symptom clusters. ClinicalTrials.gov Identifier: NCT02946619.
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Affiliation(s)
- Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ivan H C Wu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA.
- Department of Psychology, University of Houston, Houston, TX, USA.
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Kolokotroni P, Anagnostopoulos F, Hantzi A. The Role of Optimism, Social Constraints, Coping, and Cognitive Processing in Psychosocial Adjustment Among Breast Cancer Survivors. J Clin Psychol Med Settings 2019; 25:452-462. [PMID: 29468567 DOI: 10.1007/s10880-018-9555-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Indexed: 11/27/2022]
Abstract
The social-cognitive processing model suggests that a socially constrained environment may impede adjustment to a chronic illness. The present study primarily investigated the mediating psychological pathways through which social constraints on cancer-related disclosure, low optimism, disengagement-oriented coping, and brooding could be associated with low levels of psychosocial adjustment. One hundred twenty-five female breast cancer survivors participated in a cross-sectional study. Path analysis was used to examine the proposed model. Low optimism, increased social constraints, and higher levels of brooding appeared to be risk factors for poor psychosocial adjustment to breast cancer. Disengagement-oriented coping and brooding partially mediated the relationship between social constraints and adjustment. Brooding totally mediated the relationship between disengagement-oriented coping and adjustment. The current findings provide support for the value of the social-cognitive processing model among breast cancer survivors. The mapping of psychological pathways of adjustment to breast cancer may have useful clinical implications for better adjustment outcomes.
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Affiliation(s)
- Philippa Kolokotroni
- Psychology Department, Panteion University of Social & Political Sciences, 136 Syngrou Avenue, 176 71, Athens, Greece.
| | - Fotios Anagnostopoulos
- Psychology Department, Panteion University of Social & Political Sciences, 136 Syngrou Avenue, 176 71, Athens, Greece
| | - Alexandra Hantzi
- Psychology Department, Panteion University of Social & Political Sciences, 136 Syngrou Avenue, 176 71, Athens, Greece
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Secinti E, Rand KL, Johns SA, O'Neil BH, Helft PR, Shahda S, Jalal SI, Mosher CE. Social correlates of mental health in gastrointestinal cancer patients and their family caregivers: Exploring the role of loneliness. Support Care Cancer 2018; 27:2077-2086. [PMID: 30225573 DOI: 10.1007/s00520-018-4467-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 05/07/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The present study examined the degree to which loneliness mediated the influence of negative (social constraints) and positive (emotional support) relationship qualities on the global mental health of advanced gastrointestinal (GI) cancer patients and their family caregivers. METHODS Fifty patient-caregiver dyads completed measures assessing social constraints (e.g., avoidance, criticism) from the other dyad members, emotional support from others, loneliness, and global mental health. Structural equation modeling was used to examine individual models, and Actor-Partner Interdependence Mediation Modeling was used to examine dyadic associations. RESULTS Individual path analyses for patients and caregivers demonstrated that emotional support had a significant indirect effect on mental health through loneliness (Bs = 0.32 and 0.30, respectively), but no associations were found between social constraints and mental health. In dyadic analyses, participants' loneliness and mental health were not significantly related to their partner's emotional support, loneliness, or mental health (Bs = - 0.18 to 0.18). CONCLUSIONS Findings suggest that for advanced GI cancer patients and caregivers, emotional support from others alleviates feelings of loneliness, which may lead to better mental health. However, the benefits of emotional support appear to be primarily intrapersonal rather than interpersonal in nature. Additionally, participants endorsed low levels of social constraints, which might explain their lack of relation to loneliness and mental health. Continued examination of interdependence in social processes between cancer patients and caregivers will inform intervention development.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Shelley A Johns
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, 1101 W. 10th Street, RF-226, Indianapolis, IN, 46202, USA
| | - Bert H O'Neil
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Paul R Helft
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Safi Shahda
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Shadia I Jalal
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
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Adams RN, Mosher CE, Winger JG, Abonour R, Kroenke K. Cancer-related loneliness mediates the relationships between social constraints and symptoms among cancer patients. J Behav Med 2018; 41:243-52. [PMID: 28983735 DOI: 10.1007/s10865-017-9892-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/29/2017] [Indexed: 12/15/2022]
Abstract
Cancer patients have high rates of persistent and disabling symptoms. Evidence suggests that social constraints (e.g., avoidance and criticism) negatively impact symptoms, but pathways linking these variables have yet to be identified. This study examined whether cancer-related loneliness (i.e., feeling socially disconnected related to having cancer) mediated the relationships between social constraints and symptoms (i.e., pain interference, fatigue, sleep disturbance, and cognitive complaints) in patients with various cancers (N = 182). Patients (51% female, mean age = 59) were recruited from the Indiana Cancer Registry and completed questionnaires assessing social constraints, cancer-related loneliness, and symptoms. Structural equation modeling was used to evaluate the hypothesized relationships among variables. The model demonstrated good fit. Consistent with our hypothesis, cancer-related loneliness mediated the relationships between social constraints and each symptom. Findings suggest that addressing cancer-related loneliness in symptom management interventions may mitigate the negative impact of social constraints on outcomes.
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Darabos K, Hoyt MA. Masculine norms about emotionality and social constraints in young and older adult men with cancer. J Behav Med 2017; 40:259-70. [PMID: 27033539 DOI: 10.1007/s10865-016-9739-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/22/2016] [Indexed: 12/17/2022]
Abstract
Beliefs that men should restrict their display of emotions, or restrictive emotionality, might contribute to adjustment to cancer and this might be sensitive to social receptivity to disclosure. The present research examined relationships of restrictive emotionality, social constraints, and psychological distress in young adults with testicular cancer (N = 171; Study 1) and older men with prostate cancer (N = 66; Study 2). Study 1: positive associations were observed for social constraints and restrictive emotionality with depressive symptoms. Social constraints moderated the relationship, such that high restrictive emotionality was associated with higher depressive symptoms in those with high constraints. Study 2: only social constraints (and not restrictive emotionality) was positively associated with depressive symptoms and cancer-related intrusive thoughts. The social constraints × restrictive emotionality interaction approached significance with depressive symptoms, such with high social constraints low restrictive emotionality was associated with higher depressive symptoms compared to those with less constraints. No significant associations were found for intrusive thoughts in either study. Findings demonstrate unique relationships with psychological distress across the lifespan of men with cancer given perception of constraints and adherence to masculine norms about emotionality.
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Cohee AA, Stump T, Adams RN, Johns SA, Von Ah D, Zoppi K, Fife B, Monahan PO, Cella D, Champion VL. Factors associated with depressive symptoms in young long-term breast cancer survivors. Qual Life Res 2016; 25:1991-7. [PMID: 26883816 DOI: 10.1007/s11136-016-1241-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 01/30/2023]
Abstract
PURPOSE Long-term breast cancer survivors frequently report distress (i.e., depressive symptoms) that impacts their quality of life. Previous studies have found that negative social interactions ("social constraints") from partners contribute to long-term, unresolved cycling of intrusive thoughts and cognitive avoidance, resulting in psychological distress. However, these relationships have not been tested in long-term breast cancer survivors. Furthermore, the effect of partners' depressive symptoms on the survivors' depressive symptoms has not been tested within the context of these relationships. Therefore, the purpose of this study was to test relationships between breast cancer survivors' depressive symptoms and (1) social constraints, cognitive avoidance, and intrusive thoughts, and (2) partners' depressive symptoms. METHODS Data were from a cross-sectional descriptive study of breast cancer survivors (N = 222) 3-8 years post-diagnosis and their partners, who completed surveys assessing demographic characteristics, social constraints, intrusive thoughts, cognitive avoidance, and depressive symptoms. Structural equation modeling confirmatory path analyses were conducted to determine significant relationships between survivors' depressive symptoms and all other variables. RESULTS Our model fits the data well. Breast cancer survivors' depressive symptoms were predicted by social constraints and intrusive thoughts. The relationship between survivors' depressive symptoms and partners' depressive symptoms was close but not significant. CONCLUSIONS As hypothesized, depressive symptoms were predicted by social constraints and intrusive thoughts. Further research is needed to understand the possible relationship between survivors' long-term depressive symptoms and cognitive avoidance and partners' depressive symptoms. Our findings highlight the negative impact of social constraints from partners on psychological outcomes in long-term breast cancer survivors.
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