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Emotional Functioning (emotional + functioning)

Distribution by Scientific Domains

Medical Sciences	80%
Psychology	16%

Selected Abstracts

Mother,Child Planning, Child Emotional Functioning, and Children's Transition to First Grade

CHILD DEVELOPMENT, Issue 3 2009
Susan M. Perez
Mother,child planning was examined in relation to child emotional functioning and first-grade school performance. Ninety dyads were randomly assigned to the explicit-goal condition (emphasized accuracy and preparation for a child-only posttest) or the no-explicit-goal condition (dyads just asked to work together). In the no-explicit-goal condition only, children higher in negative emotionality and lower in regulation skills were less engaged in the task and planned less effectively. Both mother,child planning and adaptive child emotional functioning were positively associated with school performance. Results suggest that child emotional functioning mediated associations between planning and school performance. Implications of these findings for the development of planning and children's transition to school are discussed. [source]

Problematic internet use: Proposed classification and diagnostic criteria

DEPRESSION AND ANXIETY, Issue 4 2003
Nathan A. Shapira M.D., Ph.D.
Abstract Since the mid-1990s, there have been frequent reports of individuals whose use of the computer and internet is problematic. Given the recent expansion and the expected increase in internet availability and usage in the coming years, it is important that healthcare professionals be informed about this behavior and its associated problems. Recently, psychological and psychiatric literature has described individuals that exhibit problematic internet use who often suffer from other psychiatric disorders. In the face of this comorbidity, it is essential to evaluate whether these individuals represent a distinct class of disorder, or a manifestation/coping mechanism related to other underlying diagnosis. In either event, problematic internet use negatively impacts social and emotional functioning. Based on the current limited empirical evidence, problematic internet use may best be classified as an impulse control disorder. It is therefore imperative that problematic internet use be appropriately identified among symptomatic individuals. For these reasons, we propose specific diagnostic criteria that will allow for consistent identification and assist in further study of this behavior. Depression and Anxiety 17:207,216, 2003. © 2003 Wiley-Liss, Inc. [source]

Outcome of craniopharyngioma in children: long-term complications and quality of life

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2004
Andrea Poretti MB BS
Childhood craniopharyngiomas are histologically benign tumours arising from remnants of Rathke's pouch in the hypothalamic,pituitary region. The two common treatment approaches are primary total resection or limited resection followed by radiotherapy. To study the outcome after a primary surgical approach, we followed 25 consecutive patients (10 females, 15 males) under 16 years of age who were treated in a single institution with a management policy of radical tumour excision (mean age at diagnosis 9 years 2 months, SD 4 years 3 months; range 2 years 9 months to 15 years 11 months). Mean follow-up after primary surgery was 11 years 3 months (SD 7 years 7 months). Tumour control, and neurological, endocrine, and hypothalamic complications and their impact on health-related quality of life were assessed (medical follow-up, semi-structured interview, and questionnaires). Results of tumour control were generally good, however, local failure was observed in 6 of 25 patients, and severe late-treatment complications decreased quality of life for many long-time survivors. Endocrine deficiency occurred in 24/25, visual complications in 16/24, neurological complications in 8/24, obesity in 14/23, increased daytime sleepiness in 6/21, and significant school problems in 10/20. Patients with craniopharyngioma rated their health-related quality of life as considerably lower than healthy controls; the domains of social and emotional functioning were particularly affected. Parents'ratings were considerably lower than those of the patients. Poor functional outcome was associated with large tumours infiltrating or displacing the hypothalamus, the occurrence of hydrocephalus, and young age at diagnosis, but also with multiple operations due to tumour recurrence. Alternative treatment strategies should be considered, especially in very young patients with large tumours. [source]

Neural plasticity and human development: the role of early experience in sculpting memory systems

DEVELOPMENTAL SCIENCE, Issue 2 2000
Charles A. Nelson
The concept of sensitive or critical periods in the context of memory development is examined in this paper. I begin by providing examples of the role of experience in influencing sensory, linguistic and emotional functioning. This is followed by a discussion of the role of experience in influencing cognitive functioning, particularly memory. Based on this discussion, speculation is offered that the infant's proclivity for novelty, which makes its appearance shortly after birth, provides critical input into a nervous system that will eventually be set up to learn and remember for the entire lifespan. Because learning and memory are fundamental to the survival of our species, those aspects of the nervous system that permit the encoding and retention of new information are remarkably malleable from the outset, even in the face of some types of neural trauma. This flexibility is retained for many years so long as the learning and memory ,system' is challenged. The implications of this model are discussed in the context of those life events that might undermine the longevity of memory systems. [source]

Validity of Three Measures of Health-related Quality of Life in Children with Intractable Epilepsy

EPILEPSIA, Issue 10 2002
Elisabeth M. S. Sherman
Summary: ,Purpose: Validity studies on health-related quality of life (HRQOL) scales for pediatric epilepsy are few, and cross-validation with other samples has not been reported. This study was designed to assess the validity of three parent-rated measures of HRQOL in pediatric epilepsy: (a) the Impact of Childhood Illness Scale (ICI), (b) the Impact of Child Neurologic Handicap Scale (ICNH), and (c) the Hague Restrictions in Epilepsy Scale (HARCES). Methods: Retrospective data were examined for 44 children with intractable epilepsy. Validity was assessed by evaluating differences across epilepsy severity groups as well as correlations between HRQOL scales and neurologic variables (seizure severity, epilepsy duration, current/prior antiepileptic medications) and psychosocial measures (emotional functioning, IQ, social skills, adaptive behavior). Scale overlap with a global QOL rating also was assessed. Results: The HRQOL measures were moderately to highly intercorrelated. The scales differed in terms of their associations with criterion measures. The HARCES was related to the highest number of neurologic variables and the ICNH to the fewest. All three scales were related to psychosocial functioning and to global quality of life. Conclusions: The results of this study suggest that the three measures are likely adequate measures of HRQOL for use in intractable childhood epilepsy. The measures were highly intercorrelated, and they were all broadly related to criterion measures reflecting specific domains of HRQOL as well as global QOL. Some differences between scales emerged, however, that suggest care in choosing HRQOL instruments for children with epilepsy. [source]

Uncertainty, lack of control and emotional functioning in women with metastatic breast cancer: a review and secondary analysis of the literature using the critical appraisal technique

EUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010
M. WARREN msc, clinical nurse specialist
WARREN M. (2010) European Journal of Cancer Care19, 564,574 Uncertainty, lack of control and emotional functioning in women with metastatic breast cancer: a review and secondary analysis of the literature using the critical appraisal technique A diagnosis of metastatic (or secondary) breast cancer is frequently more distressing than the diagnosis of a primary tumour since it indicates that the cancer is no longer curable. Relatively little is known, however, about women's experiences of this condition in comparison with those diagnosed with primary breast cancer. This paper therefore reports findings from a secondary analysis of the published literature on the topic using tools from the critical appraisal skills programme to identify and analyse appropriate papers, and the constant comparative method as a means of identifying any overarching or dominant themes emerging from the literature. Uncertainty, lack of control and poor emotional functioning emerged as the main themes affecting women with metastatic breast cancer. These are discussed in relation to their antecedents in the original studies and their implications for nursing care. The themes demonstrate that living with metastatic (or secondary) breast cancer is a multifaceted experience that is influenced by a large number of factors, many of which are under-researched in comparison with those affecting women diagnosed with primary disease. It is clear, however, that women affected by the condition need a great deal more support than they currently receive, and new services may be required to meet these needs. [source]

The Ages & Stages Questionnaire: Social,Emotional: A validation study of a mother-report questionnaire on a clinical mother,infant sample,

INFANT MENTAL HEALTH JOURNAL, Issue 4 2010
Björn Salomonsson
Mother-report questionnaires of infant socioemotional functioning are increasingly used to screen for clinical referral to infant mental health services. The validity of the Ages & Stages Questionnaire: Social Emotional (ASQ:SE; J. Squires, D. Bricker, K. Heo, & E. Twombly, 2002) was investigated in a sample of help-seeking mothers with young infants. It was compared with independent observer-rated dyadic interactions, and the quality of dyadic relationships was rated by expert clinicians. The ASQ:SE ratings also were compared with questionnaires on maternal psychological stress and distress. The ASQ:SE did not correlate significantly with either external ratings of dyadic interaction or clinically assessed relationship qualities, though the latter two were strongly associated with each other. In contrast, ASQ:SE scores were associated with questionnaires relating to maternal psychological distress. This was especially true for mothers classified as depressed. Furthermore, reports on the ASQ:SE were strongly predicted by maternal stress. The study points to some problems with the concurrent validity of the ASQ:SE in clinical samples. It also demonstrates a close link between mothers' psychological distress and their ratings of infant social and emotional functioning. Further research should investigate the extent to which the ASQ:SE specifically measures infant functioning or maternal distress, and how it functions in clinical versus nonclinical samples. Los cuestionarios en que las madres reportan el funcionamiento socio-emocional del infante se están usando más para determinar la necesidad de referir a los servicios de salud mental infantil. Se investigó la validez del Cuestionario de Edades y Niveles: Socio-emocional (ASQ:SE) en un grupo muestra de madres con infantes pequeños las cuales buscaban ayuda. Al grupo se le comparó con las interacciones de las díadas evaluadas por un observador independiente, y con la calidad de las relaciones de las díadas evaluadas por clínicos expertos. Los puntajes del ASQ:SE también fueron comparados con cuestionarios sobre el estrés y la ansiedad maternales sicológicas. Resultados: el ASQ:SE no se correlacionó significativamente ni con los puntajes externos de la interacción de la díada ni con las cualidades de la relación evaluadas clínicamente, aunque ambas fueron asociadas fuertemente una con la otra. En contraste, los puntajes de ASQ:SE fueron asociados con cuestionarios que se referían a la ansiedad mental psicológica maternal. Esto resultó verdadero sobretodo en los casos de madres clasificadas como depresivas. Es más, el estrés maternal predijo fuertemente los reportes sobre el ASQ:SE. Este estudio apunta hacia ciertos problemas con la validez concurrente del ASQ:SE en muestras clínicas. El mismo demuestra una conexión cercana entre la ansiedad mental psicológica maternal y los puntajes que las madres les dan al funcionamiento social y emocional del infante. La investigación futura debe enfocarse en hasta qué punto el ASQ:SE mide específicamente el funcionamiento del infante o la ansiedad mental de la madre, y cómo el mismo funciona en muestras clínicas versus aquellas que no lo son. Les questionnaires "rapport de la mère" de fonctionnement social et émotionnel du nourrison sont de plus en plus utilisés pour tester les enfants afin de les envoyer consulter en services de santé mentale du nourrisson. La validité du questionnaire "âge et étapes: social et émotionnel" (en anglais Ages and Stages Questionnaire: Social et Emotionnel, abrégé ASQ:SE en anglais) a été examinée chez un échantillon de mères de jeunes bébés cherchant de l'aide. Elle a été comparée à des interactions dyadiques évaluées par un observateur indépendant, la qualité des relations dyadiques étant évaluée par des cliniciens experts. Les évaluations ASQ:SE ont aussi été comparées aux questionnaires sur la détresse et le stress psychologique maternel. Résultats: Le questionnaire ASQ:SE n'a pas été fortement mis en corrélation avec soit les évaluations externes d'interaction dyadique soit les qualités de la relation évaluées cliniquement, bien que ces deux dernières aient été fortement liées les unes aux autres. Par contre, les scores ASQ:SE étaient liés aux questionnaires qui portaient sur la détresse psychologique maternelle. Ceci s'est surtout avéré vrai pour les mères classifiées comme déprimées. De plus, les rapports sur le ASQ:SE étaient frotement prédits par le stress maternel. Cette étude met en lumière certains problèmes avec la validité simultanée du questionnaire ASQ:SE dans les échantillons cliniques. Elle démontre aussi un lien étroit entre la détresse psychologique des mères et leurs évaluations du fonctionnement social et émotionnel du nourrisson. Des recherches plus approfondies devraient porter sur la mesure dans laquelle le questionnaire ASQ:SE mesure spécifiquement le fonctionnement du nourrisson ou la détresse maternelle, et comment il fonctionne dans des échantillons cliniques par rapport à non-cliniques. Fragebögen der sozial-emotionalen Funktionsweisen, die auf Elternurteilen beruhen, werden zunehmend zur Klärung der Frage eingesetzt, ob eine ärztliche Überweisung im Rahmen von psychischer Gesundheit im Kleinkindalter induziert ist. Die Gültigkeit des Fragebogens zum Alter und zu den Entwicklungsstufen "Sozial Emotional" (ASQ: SE) wurde von einer Gruppe Hilfe-suchender Mütter mit Kleinkindern entwickelt. Die Fragebögen wurden von unabhängigern Beobachter innerhalb dyadischer Interaktionen validiert. Zusätzlich überprüften erfahrene Kliniker die Qualität der dyadischen Beziehungen. Die Bewertungen mittels ASQ: SE wurden darüber hinaus mit Fragebogen zu mütterlichen psychologischem Stress und Ängste verglichen. Ergebnisse: Die ASQ: SE zeigte keine signifikant Korrelation mit den externen Ergebnissen der dyadischen Interaktion oder den klinisch beurteilten Beziehungsqualitäten, obwohl die beiden letzteren trotzdem in Zusammenhang standen. Im Gegensatz dazu zeigten die Ergebnisse des ASQ: SE einen Zusammenhang mit den Fragebögen zur mütterlichen psychischen Belastung. Dies galt vor allem für Mütter die als depressiv eingestuft wurden. Außerdem machten die Ergebnisse des ASQ: SE eindeutige Vorhersagen was den mütterlicher Stress anbelangt. Die Studie weist auf einige Probleme der übereinstimmenden Gültigkeit des ASQ: SE in klinischen Stichproben hin. Es zeigt aber auch eine enge Verbindung zwischen mütterlicher psychischer Belastung und ihren Bewertungen der sozialen und emotionalen Funktionsfähigkeit ihrer Säuglinge hin. Weitere Forschung sollte untersuchen, inwieweit der ASQ: SE gezielt Maßnahmen zur Steigerung der Funktionalität von Säuglingen oder mütterliche Not misst und in wie weit der Fragebogen im klinischen bzw. nicht-klinischen Setting Gültigkeit behält. [source]

Preliminary evidence supporting a framework of psychological adjustment to inflammatory bowel disease,

INFLAMMATORY BOWEL DISEASES, Issue 10 2010
Jennifer L. Kiebles PhD
Abstract Background: Adjustment to chronic disease is a multidimensional construct described as successful adaptation to disease-specific demands, preservation of psychological well-being, functional status, and quality of life. Inflammatory bowel disease (IBD) can be particularly challenging due to the unpredictable, relapsing and remitting course of the disease. Methods: All participants were patients being treated in an outpatient gastroenterology clinic at a university medical center. Participants completed a survey of questionnaires assessing illness perceptions, stress, emotional functioning, disease acceptance, coping, disease impact, and disease-specific and health-related quality of life. Adjustment was measured as a composite of perceived disability, psychological functioning, and disease-specific and health-related quality of life. Results: Participants were 38 adults with a diagnosis of either Crohn's disease (45%) or ulcerative colitis (55%). We observed that our defined adjustment variables were strongly correlated with disease characteristics (r = 0.33,0.80, all P < 0.05), an emotional representation of illness (r = 0.44,0.58, P < 0.01), disease acceptance (r = 0.34,0.74, P < 0.05), coping (r = 0.33,0.60, P < 0.05), and frequency of gastroenterologist visits (r = 0.39,0.70, P < 0.05). Better adjustment was associated with greater bowel and systemic health, increased activities engagement and symptom tolerance, less pain, less perceived stress, and fewer gastroenterologist visits. All adjustment variables were highly correlated (r = 0.40,0.84, P < 0.05) and demonstrated a cohesive composite. Conclusions: The framework presented and results of this study underscore the importance of considering complementary pathways of disease management including cognitive, emotional, and behavioral factors beyond the traditional medical and psychological (depression and anxiety) components. (Inflamm Bowel Dis 2010) [source]

Health-related quality of life improves in children and adolescents with inflammatory bowel disease after attending a camp sponsored by the Crohn's and colitis foundation of America

INFLAMMATORY BOWEL DISEASES, Issue 2 2005
Melissa A. Shepanski MS
Abstract Purpose: To describe the reported health-related quality of life (HRQOL) in children and adolescents with inflammatory bowel disease (IBD) after attending an IBD summer camp. Methods: A prospective analysis of quality of life was completed at an overnight camp that was exclusively for patients with IBD, which was sponsored by the Crohn's and Colitis Foundation of America. The IMPACT-II questionnaire (Canada and United States) and the State-Trait Anxiety Inventory for Children were administered to the campers at the beginning and at the end of a 1-week camp to assess HRQOL and anxiety. The IMPACT-II questionnaire consists of 35 questions measuring 6 quality-of-life domains (i.e., bowel domain, systemic symptoms, emotional functioning, social functioning, body image, and treatment/interventions). The State-Trait Anxiety Inventory for Children consists of 2 different 20-item sets of questions. One set assesses state anxiety, and the other, trait anxiety. A repeated-measures multivariate analysis of variance was performed to determine the differences between scores attained before and after camp on the IMPACT-II questionnaire and in each of its domains. Paired sample t tests were performed on state and trait anxiety before and after camp. Results: A total of 125 individuals consented to participate, but 61 patients (50 girls and 11 boys; age range, 9 to 16 y) completed the IMPACT-II questionnaire in full. Of those 61 patients, 47 had Crohn's disease and 14 had ulcerative colitis. There was statistically significant improvement between the mean (±SD) precamp total score (172.95 ± 36.61) and the mean postcamp total score (178.71 ± 40.97; P = 0.035), bowel symptoms scores (P = 0.036), social functioning scores (P = 0.022), and treatment interventions scores (P = 0.012). No difference was found between anxiety scores before and after camp on either the state or trait anxiety inventories (n = 55; P > 0.05). Conclusions: Overall, HRQOL improved in children after attending IBD summer camp. This exploratory study suggests that contributing factors for these improvements may be an increase in social functioning, a better acceptance of IBD symptoms, and less distress regarding treatment interventions, suggesting that a camp that is specifically designed for children with IBD may normalize the chronic illness experience. However, future research using a multimodal measurement approach is warranted to support these conclusions. [source]

Functional and Cognitive Consequences of Silent Stroke Discovered Using Brain Magnetic Resonance Imaging in an Elderly Population

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2004
Wolf-Peter Schmidt MD
Objectives: To evaluate the prevalence of silent stroke and its associated consequences on physical, cognitive, and emotional functioning in an elderly population. Design: Population-based cross-sectional survey. Setting: The Memory and Morbidity in Augsburg Elderly project in the Augsburg region of southern Germany. Participants: Two hundred sixty-seven community-dwelling persons aged 65 to 83. Measurements: The presence of silent stroke was determined using magnetic resonance imaging brain scan and a single question asking for physician-diagnosed stroke in each participant. The health effect of silent stroke was assessed using rating scales for self-perceived health status (36-item short-form health survey), activities of daily living (ADLs) and instrumental ADLs, cognitive function, and depression (Center for Epidemiologic Studies Depression scale). Results: Just fewer than 13% (12.7%) of participants were affected by silent stroke. Silent stroke was associated with a history of hypertension, heart surgery, and elevated C-reactive protein. Individuals with silent stroke showed impairments on the Mini-Mental State Examination test and in the cognitive domains of memory, procedural speed, and motor performance. Conclusion: The presence of silent stroke has a considerable effect on cognitive performance in those affected. Determining the presence of silent stroke using brain imaging may contribute to identifying individuals at risk for developing gradual neurological deficits. [source]

Blunted Rostral Anterior Cingulate Response During a Simplified Decoding Task of Negative Emotional Facial Expressions in Alcoholic Patients

ALCOHOLISM, Issue 9 2007
Jasmin B. Salloum
Background:, Alcoholism is characterized by deficits in emotional functioning as well as by deficits in cognitive functioning. However, most brain imaging research on alcoholism has focused on cognition rather than emotion. Method:, We used an event-related functional magnetic imaging approach to examine alcoholics' brain blood oxygenation level dependent (BOLD) response to evaluation of emotional stimuli and to compare their response to that of nonalcoholic controls. The task used was a simplified variant of a facial emotion-decoding task in which subjects determined the intensity level of a target emotion displayed as a facial expression. Facial expressions of happy, sad, anger, disgust, and fear were used as stimuli. Results:, Alcoholics and controls did not differ in accurately identifying the intensity level on the simple emotional decoding task but there were significant differences in their BOLD response during evaluation of facial emotion. In general, alcoholics showed less brain activation than nonalcoholic controls. The greatest differences in activation were during decoding of facial expressions of fear and disgust during which alcoholics had significantly less activation than controls in the affective division of the anterior cingulate cortex (ACC). Alcoholics also had significantly less activation than controls in the affective division of the ACC, while viewing sad faces. Only to facial expressions of anger did the alcoholics show significant activation in the affective ACC and in this case, their BOLD response did not significantly differ from that of the controls. Conclusion:, Alcoholics show a deficit in the function of the affective division of the ACC during evaluation of negative facial emotions that can serve as cues for flight or avoidance. This deficit may underlie some of the behavioral dysfunction in alcoholism. [source]

Measuring health-related quality of life in women with urogenital dysfunction: The urogenital distress inventory and incontinence impact questionnaire revisited

NEUROUROLOGY AND URODYNAMICS, Issue 2 2003
C. Huub van der Vaart
Abstract Aims Symptoms of urogenital dysfunction are known to negatively affect health-related quality of life in women. To assess effectiveness of treatment, it is currently recommended to include measurements of quality of life in outcome analysis. One of the questionnaires that is commonly used is the combination of the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ). Unfortunately, the validity of the UDI and IIQ has only been tested in highly selected subgroups of female patients. Therefore, it is unclear whether this questionnaire is suitable for use in populations with different characteristics. Methods We analyzed the scale construction and validity of the UDI and IIQ in a random sample of 2,042 women, aged 20,70 years old and a clinical sample of 196 women. Results Our results show that the UDI can be divided into five subscales, namely discomfort/pain, urinary incontinence, overactive bladder, genital prolapse, and obstructive micturition. The internal consistency (Cronbach's alpha) ranged between 0.74 and 0.82. In addition to the original four subscales of the IIQ (mobility, physical, social, and emotional functioning), we identified a fifth subscale with four items about embarrassment. Internal consistency of these subscales ranged between 0.83 and 0.93. In addition to the internal consistency, we tested the criterion and construct validity of these new subscale division. Conclusions We found these subscales to be reliable and of clinical use. It is recommended to use the revised UDI and IIQ in outcome analysis of treatments for urogenital symptoms in women. Neurourol. Urodynam. 22:97,104, 2003. © 2003 Wiley-Liss, Inc. [source]

Symptoms of depression and anxiety in patients with thalassemia: Prevalence and correlates in the thalassemia longitudinal cohort,

AMERICAN JOURNAL OF HEMATOLOGY, Issue 10 2010
Lauren Mednick
Thalassemia is an inherited blood disorder that requires lifelong adherence to a complicated and burdensome medical regimen which could potentially impact emotional functioning of patients. The importance of understanding and promoting healthy emotional functioning is crucial not only to psychological well-being, but also to physical health as it has been shown to impact adherence to medical regimens [1,4]. The current study aimed to [1] determine the prevalence of depressive and anxiety symptoms in adolescent and adult patients with thalassemia; and [2] explore possible demographic, medical, and psychosocial correlates of these symptoms in 276 patients (14,58 years old, M age = 27.83; 52% female). Overall, most patients did not report experiencing significant symptoms of anxiety and depression (33% of participants indicated experiencing symptoms of anxiety and 11% symptoms of depression). Females and older patients were more likely to experience these symptoms than males and younger patients. Symptoms of anxiety and depression were positively associated with self-report of difficulty with adherence and negatively associated with quality of life. Given these findings, regular screening for anxiety and depression symptoms could help to identify at-risk individuals to provide them with appropriate psychological support with the goal of improving both emotional and physical health. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source]

Cancer Pain: An Age-Based Analysis

PAIN MEDICINE, Issue 10 2010
Carmen R. Green MD
Abstract Objective., Although cancer pain (consistent and breakthrough pain [BTP; pain flares interrupting well-controlled baseline pain]) is common among cancer patients, its characteristics, etiology, and impact on health-related quality of life (HRQOL) across the lifespan are poorly understood. Design., This longitudinal study examines age-based differences and pain-related interference in young and old patients with cancer-related pain over 6 months. Patients in the community with stage III or IV breast, prostate, colorectal, or lung cancer, or stage II,IV multiple myeloma with BTP completed surveys (upon initial assessment, 3 and 6 months) assessing consistent pain, BTP, depressed affect, active coping ability, and HRQOL using previously validated measures. Results., Respondents (N = 96) were 70% white and 66% female, with a mean age of 57 ± 10 years. There were no significant differences in pain severity based upon age. However, the younger group experienced more pain flares with greater frequency (P = 0.05). The oldest group had better emotional functioning at baseline but worse physical functioning at 6 months. Younger groups also had worse cognitive functioning at 6 months (P = 0.03). Pain interference was independent of age. Conclusions., These data provide evidence for the significant toll of cancer pain on overall health and well-being of young and old adults alike but demonstrate an increased toll for younger adults (especially financially). Beyond race and gender disparities, further health care disparities in the cancer and cancer pain were identified by age, illustrating the need for additional research across the lifespan in diverse cancer survivors. [source]

painACTION-Back Pain: A Self-Management Website for People with Chronic Back Pain

PAIN MEDICINE, Issue 7 2010
Emil Chiauzzi PhD
Abstract Objective., To determine whether an interactive self-management Website for people with chronic back pain would significantly improve emotional management, coping, self-efficacy to manage pain, pain levels, and physical functioning compared with standard text-based materials. Design., The study utilized a pretest,posttest randomized controlled design comparing Website (painACTION-Back Pain) and control (text-based material) conditions at baseline and at 1-, 3, and 6-month follow-ups. Participants., Two hundred and nine people with chronic back pain were recruited through dissemination of study information online and at a pain treatment clinic. The 6-month follow-up rates for the Website and control groups were 73% and 84%, respectively. Measurements., Measures were based on the recommendations of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials and included measures of pain intensity, physical functioning, emotional functioning, coping, self-efficacy, fear-avoidance, perceived improvement with treatment, self-efficacy, and catastrophizing. Results., Compared with controls, painACTION-Back Pain participants reported significantly: 1) lower stress; 2) increased coping self-statements; and 3) greater use of social support. Comparisons between groups suggested clinically significant differences in current pain intensity, depression, anxiety, stress, and global ratings of improvement. Among participants recruited online, those using the Website reported significantly: 1) lower "worst" pain; 2) lower "average" pain; and 3) increased coping self-statements, compared with controls. Participants recruited through the pain clinic evidenced no such differences. Conclusions., An online self-management program for people with chronic back pain can lead to improvements in stress, coping, and social support, and produce clinically significant differences in pain, depression, anxiety, and global rates of improvement. [source]

Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients

PSYCHO-ONCOLOGY, Issue 10 2006
Cindy L. Carmack Taylor
Abstract Background: Active for Life After Cancer is a randomized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program (Lifestyle) for prostate cancer patients to improve quality of life (QOL) including physical and emotional functioning compared to a group-based Educational Support Program and a Standard Care Program (no group). Method: A total of 134 prostate cancer patients receiving continuous androgen-ablation were randomly assigned to one of the three study conditions. Results: Results indicated no significant improvements in QOL at 6 or 12 months. Both group-based programs were positively received and yielded good attendance and retention. Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity. Despite these improvements, no significant changes were found for most physical activity measures. Conclusions: Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Genetic and environmental influences on the transmission of parental depression to children's depression and conduct disturbance: an extended Children of Twins study

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 6 2010
Judy L. Silberg
Background:, Despite the increased risk of depression and conduct problems in children of depressed parents, the mechanism by which parental depression affects their children's behavioral and emotional functioning is not well understood. The present study was undertaken to determine whether parental depression represents a genuine environmental risk factor in children's psychopathology, or whether children's depression/conduct can be explained as a secondary consequence of the genetic liability transmitted from parents to their offspring. Methods:, Children of Twins (COT) data collected on 2,674 adult female and male twins, their spouses, and 2,940 of their children were used to address whether genetic and/or family environmental factors best account for the association between depression in parents and depression and conduct problems in their children. Data collected on juvenile twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) were also included to estimate child-specific genetic and environmental influences apart from those effects arising from the transmission of the parental depression itself. The fit of alternative Children of Twin models were evaluated using the statistical program Mx. Results:, The most compelling model for the association between parental and juvenile depression was a model of direct environmental risk. Both family environmental and genetic factors accounted for the association between parental depression and child conduct disturbance. Conclusions:, These findings illustrate how a genetically mediated behavior such as parental depression can have both an environmental and genetic impact on children's behavior. We find developmentally specific genetic factors underlying risk to juvenile and adult depression. A shared genetic liability influences both parental depression and juvenile conduct disturbance, implicating child conduct disturbance (CD) as an early indicator of genetic risk for depression in adulthood. In summary, our analyses demonstrate differences in the impact of parental depression on different forms of child psychopathology, and at various stages of development. [source]

ORIGINAL RESEARCH,PAIN: Pain, Psychosocial, Sexual, and Psychophysical Characteristics of Women with Primary vs.

THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2009
Secondary Provoked Vestibulodynia
ABSTRACT Introduction., Women with provoked vestibulodynia (PVD), a common cause of dyspareunia, are typically considered a homogeneous group. However, research suggests that differences on some factors (e.g., medical history, pain characteristics, psychological functioning, treatment response) exist based upon whether the pain was present at first intercourse (primary PVD: PVD1) or developed at some later point (secondary PVD: PVD2). Aims., The purpose of this study was to examine differences in demographic variables, pain characteristics, psychosocial and psychosexual adjustment, and pain sensitivity between women with PVD1 and PVD2. Methods., Twenty-six women suffering from PVD (13 with PVD1 and 13 with PVD2) completed a screening assessment, a standardized gynecological examination, an interview, questionnaires, and a quantitative sensory testing session. Main Outcome Measures., These included pain ratings during the gynecological examination and interview, scores on measures of psychosocial/sexual functioning (e.g., Short Form-36 [SF-36] Health Survey, Female Sexual Function Index), and thresholds and pain ratings during thermal sensory testing over the dominant forearm and vulvar vestibule. Results., The women with PVD1 were more likely to be nulliparous, but they were not significantly different from the women with PVD2 on other demographic variables or in their pain ratings during the gynecological examination. The women with PVD1 reported lower levels of social and emotional functioning and heightened anxiety surrounding body exposure during sexual activity, and they also displayed lower heat pain tolerance over the forearm and lower heat detection and pain thresholds at the vulvar vestibule than the women with PVD2. Conclusions., The findings from this study support previous research indicating that women with PVD1 and PVD2 differ in a number of domains. Further research is needed to confirm and elaborate on these findings. Sutton KS, Pukall C, and Chamberlain S. Pain, psychosocial, sexual, and psychophysical characteristics of women with primary vs. secondary provoked vestibulodynia. J Sex Med 2009;6:205,214. [source]

Quality of life, sexual function and decisional regret at 1 year after surgical treatment for localized prostate cancer

BJU INTERNATIONAL, Issue 4 2007
B. Joyce Davison
OBJECTIVE To examine the effect of changes in quality of life (QoL) and levels of sexual function on decisional regret after surgical treatment of localized prostate cancer. PATIENTS AND METHODS Patients who decided to have a radical prostatectomy (RP) were assessed for health-related QoL using the general European Organization for Research and Treatment of Cancer C30 instrument and disease-specific prostate cancer module, and sexual function using the abbreviated International Index of Erectile Function-5 before and 1 year after RP. Decision control was measured before RP, and decisional regret 1 year afterward, using measures mailed to participants 1 year after treatment. RESULTS Of 130 respondents (mean age 62 years), 4% expressed regret over their decision to have surgery. Physical and social functioning, and finances, were compromised, while emotional functioning and treatment-related symptoms improved by 1 year. Higher levels of decisional regret were correlated with decreases in role and social functioning, increased pain and financial difficulty (all P < 0.01). Sexual function was decreased (P < 0.001) after treatment. Men reported feeling less masculine, having less sexual enjoyment, difficulty in getting and maintaining an erection, and discomfort when being sexually intimate after surgery. Mean scores of decisional regret were similar among patients who reported assuming either active (84%) or collaborative (11%) roles in treatment decision-making. Men who assumed a passive role reported the most variability and highest scores on decision regret. CONCLUSIONS Few men regretted having RP at 1 year after treatment, even though some QoL functions and domains were significantly affected. Ongoing assessment of the effect of surgical treatment on sexual function, sexuality and masculinity certainly deserves further exploration with this group of cancer survivors. [source]

Reliability and validity of the Childhood Cancer Survivor Study Neurocognitive Questionnaire

CANCER, Issue 8 2008
Kevin R. Krull PhD
Abstract BACKGROUND. Up to 40% of childhood cancer survivors may experience neurocognitive impairment in 1 or more specific domains. As such, regular monitoring has been recommended for patients exposed to cranial irradiation and/or antimetabolite chemotherapy. This study reports the results of a questionnaire developed to identify those survivors who may be experiencing neurocognitive problems. METHODS. Participants for this study were 7121 members of the Childhood Cancer Survivor Study cohort (6739 survivors and 382 siblings). These participants completed a new neurocognitive questionnaire designed to assess functions commonly affected by cancer therapy, as well as a standard measure of emotional functioning. A measure of cognitive and emotional functioning was also completed on a subset of the patients roughly 7 years before the current questionnaire. Responses to the questionnaires among subgroups of survivors were then analyzed to examine the reliability and validity of the new neurocognitive questionnaire. RESULTS. Four reliable factors were identified that assessed task efficiency, emotional regulation, organization, and memory skills. These neurocognitive factors accurately discriminated survivors who were at "high risk" for neurocognitive dysfunction, because of neurologic abnormalities or a history of intensive focal cranial irradiation, from healthy "low-risk" survivors and siblings. CONCLUSIONS. The questionnaire demonstrated excellent reliability, as well as construct and discriminative validity. It appears to be a practical and efficient tool for monitoring neurocognitive outcomes in adult survivors of pediatric cancer. Cancer 2008. © 2008 American Cancer Society. [source]

Physical and psychological long-term and late effects of cancer,

CANCER, Issue S11 2008
Kevin D. Stein PhD
Abstract The number of long-term cancer survivors (,5 years after diagnosis) in the U.S. continues to rise, with more than 10 million Americans now living with a history of cancer. Along with such growth has come increasing attention to the continued health problems and needs of this population. Many cancer survivors return to normal functioning after the completion of treatment and are able to live relatively symptom-free lives. However, cancer and its treatment can also result in a wide range of physical and psychological problems that do not recede with time. Some of these problems emerge during or after cancer treatment and persist in a chronic, long-term manner. Other problems may not appear until months or even years later. Regardless of when they present, long-term and late effects of cancer can have a negative effect on cancer survivors' quality of life. This article describes the physical and psychological long-term and late effects among adult survivors of pediatric and adult cancers. The focus is on the prevalence and correlates of long-term and late effects as well as the associated deficits in physical and emotional functioning. In addition, the emergence of public health initiatives and large-scale research activities that address the issues of long-term cancer survivorship are discussed. Although additional research is needed to fully understand and document the long-term and late effects of cancer, important lessons can be learned from existing knowledge. Increased awareness of these issues is a key component in the development of follow-up care plans that may allow for adequate surveillance, prevention, and the management of long-term and late effects of cancer. Cancer 2008. © 2008 American Cancer Society. [source]