The role of goal adjustment in symptoms of depression, anxiety and fatigue in cancer patients receiving psychosocial care: a longitudinal study.
Psychol Health. 2014 Sep 29;:1-35
Authors: Zhu L, Ranchor AV, van der Lee M, Garssen B, Sanderman R, Schroevers MJ
Abstract Objective: This study examined whether cancer patients reported increases in their goal adjustment capacities while receiving psychosocial care and whether these increases were related to changes in symptoms of depression, anxiety, and fatigue. Goal adjustment was conceptualized as two independent capacities: goal disengagement (i.e. disengage from unattainable goals) and goal reengagement (i.e. reengage into new goals). Design: This naturalistic, longitudinal study focused on 241 cancer patients receiving psychosocial care at one of the seven psycho-oncology institutions in the Netherlands. Data was collected before the start of psychosocial care (T1) and nine months thereafter (T2). Hierarchical regression analysis was used to examine the research questions. Main Outcome Measures: Goal adjustment, and symptoms of depression, anxiety and fatigue. Results: At group level, patients reported small increases in goal disengagement (d = 0.22) but no significant change in goal reengagement (d = 0.09). At an individual level, 34% of cancer patients reported an increase in goal disengagement and 30% an increase in goal reengagement. Increases in goal reengagement were significantly associated with decreases in both depressive and anxiety symptoms, but not to changes in fatigue. Conclusion: Findings indicate that particularly improvements in goal reengagement are beneficial for cancer patients’ psychological functioning.
PMID: 25264270 [PubMed - as supplied by publisher]
Receiving Instrumental Support in Late Parent-Child Relationships and Parental Depression.
J Gerontol B Psychol Sci Soc Sci. 2014 Sep 23;
Authors: Djundeva M, Mills M, Wittek R, Steverink N
OBJECTIVES: This study investigates the role of gender, functional limitations, and social interaction in the association between instrumental support from adult children and parental depression. We apply self-determination theory to hypothesize about the role of physical needs and social resources on parental depression in a European context.
METHOD: A sample of 6,268 parents older than 65 who have nonresident children from the first wave of Survey of Health, Ageing and Retirement in Europe (2004) is analyzed. We estimate logistic regression models to test for the association between instrumental support and depression. Physical needs, gender, and social interaction are used as moderators.
RESULTS: Net of core factors that contribute to depression, including previous history of depression, there is a U-shaped pattern between receiving instrumental support and depression that persists across country regimes. For respondents with medium physical limitations, too little or too frequent support from children is associated with higher depression. For respondents with severe limitations, receiving at least some support is better than receiving none at all. The receipt of too frequent support from children increases the level of depression more for women than men. All interaction effects are comparable across country regimes.
DISCUSSION: Heterogeneity in physical needs and resources of older individuals must be taken into account when assessing the effects of instrumental support on mental health.
PMID: 25253024 [PubMed - as supplied by publisher]
Trajectories of personal control in cancer patients receiving psychological care.
Psychooncology. 2014 Sep 23;
Authors: Zhu L, Schroevers MJ, van der Lee M, Garssen B, Stewart RE, Sanderman R, Ranchor AV
OBJECTIVE: This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential patterns of psychological symptoms between trajectories.
METHODS: This naturalistic study focused on 241 cancer patients receiving psychological care at psycho-oncology institutions. Data were collected before the initiation of psychological care, and 3 and 9 months thereafter. Latent class growth analysis was applied to identify personal control trajectories.
RESULTS: Three personal control trajectories were identified: enduring improvement (41%), temporary improvement (50%), and deterioration (9%). Education and baseline physical symptoms distinguished these trajectories. In the whole group, improvements in personal control were associated with improvements in psychological symptoms. Patients at distinct trajectories reported different levels of psychological symptoms, but did not differ in their courses of psychological symptoms. Patients in the enduring and temporary control improvement groups experienced significant psychological symptoms reductions over time, whereas patients in the control deterioration group maintained high psychological symptoms.
CONCLUSIONS: Improvements in personal control seem to depend on initial control level: those who start with the highest control levels show subsequent improvements, whereas those with the lowest control levels show subsequent deterioration. Copyright © 2014 John Wiley & Sons, Ltd.
PMID: 25251894 [PubMed - as supplied by publisher]
[Ill after drinking untreated milk; 'die Amelander Krankheit'].
Ned Tijdschr Geneeskd. 2013;157(51):A7078
Authors: Jacobs JJ, Sanderman R
In 2012 three patients consulted their general practitioner with symptoms of gastro-enteritis with bloody stools. This was caused by drinking untreated milk infected with Campylobacter jejuni. Another patient developed reactive arthritis. He too had drunk untreated milk that had probably been infected with Yersinia enterocolitica. Between 1958 and 1995 many German children living in the region of Cologne developed gastro-enteritis after holidaying on Ameland, one of the Dutch islands. This condition was known as ‘die Amelander Krankheit’, and was caused by drinking untreated milk that had been infected with Campylobacter jejuni. After instructions to boil the milk before drinking were followed, the illness disappeared. These cases show that consumption of untreated milk can have negative consequences for health. Hence, if patients develop gastroenteritis symptoms after visiting a farm we recommend that the possibility that they may have drunk untreated milk is taken into account.
PMID: 24345367 [PubMed - indexed for MEDLINE]
Opinions of Dutch Liver Transplant Recipients on Anonymity of Organ Donation and Direct Contact With the Donor’s Family.
Transplantation. 2014 Sep 10;
Authors: Annema C, Op den Dries S, van den Berg AP, Ranchor AV, Porte RJ
BACKGROUND: In the Netherlands, anonymity of organ donation, which is currently protected by legislation, has come under discussion. In the Dutch society, a tendency to allow direct contact between transplant recipients and their donor’s family is noticeable. As little is known about the opinion of Dutch liver transplant recipients on anonymity of organ donation and direct contact with the donor’s family, this study examines their opinions.
METHODS: A cross-sectional study was conducted in 244 liver transplant recipients. Their opinions were examined in relation to demographic, transplant-related and emotional variables. Data were collected by questionnaire. Transplant-related variables were retrieved from the hospital’s liver transplant database.
RESULTS: Fifty-three percent of the respondents (n=177) agreed with anonymity of organ donation, mainly out of respect for the donor. Living situation, age, and level of positive affect influenced this opinion. The majority of the respondents (65%) indicated that they would like to receive some information about their donor, like age, sex, and health status. Only 19% of the respondents favored direct contact with the donor’s family, mainly to express their gratitude personally. Respondents transplanted for alcoholic cirrhosis were less in favor of direct contact. Respondents with feelings of guilt doubted more about direct contact.
CONCLUSION: There is no need to change the current legislation on anonymity of organ donation. However, most liver transplant recipients would like to receive some general information about their donor. Therefore, clear guidelines on the sharing of donor data with recipients need to be established.
PMID: 25211521 [PubMed - as supplied by publisher]
The effects of a problem solving-based intervention on depressive symptoms and HIV medication adherence are independent.
PLoS One. 2014;9(1):e84952
Authors: Gross R, Bellamy SL, Chapman J, Han X, O’Duor J, Strom BL, Houts PS, Palmer SC, Coyne JC
Depression and depressive symptoms predict poor adherence to medical therapy, but the association is complex, nonspecific, and difficult to interpret. Understanding this association may help to identify the mechanism explaining the results of interventions that improve both medical therapy adherence and depressive symptoms as well as determine the importance of targeting depression in adherence interventions. We previously demonstrated that Managed Problem Solving (MAPS) focused on HIV medication adherence improved adherence and viral load in patients initiating a new antiretroviral regimen. Here, we assessed whether MAPS improved depressive symptoms and in turn, whether changes in depressive symptoms mediated changes in adherence and treatment outcomes. We compared MAPS to usual care with respect to presence of depressive symptoms during the trial using logistic regression. We then assessed whether MAPS’ effect on depressive symptoms mediated the relationship between MAPS and adherence and virologic outcomes using linear and logistic regression, respectively. Mediation was defined by the disappearance of the mathematical association between MAPS and the outcomes when the proposed mediator was included in regression models. Although MAPS participants had a lower rate of depressive symptoms (OR = 0.45, 95% confidence interval 0.21-0.93), there was no evidence of mediation of the effects of MAPS on adherence and virological outcome by improvements in depression. Thus, interventions for medication adherence may not need to address depressive symptoms in order to impact both adherence and depression; this remains to be confirmed, however, in other data.
PMID: 24400124 [PubMed - indexed for MEDLINE]
Posted in PLoS One
Tagged J.C. Coyne
Mindfulness training in a heterogeneous psychiatric sample: outcome evaluation and comparison of different diagnostic groups.
J Clin Psychol. 2014 Jan;70(1):60-71
Authors: Bos EH, Merea R, van den Brink E, Sanderman R, Bartels-Velthuis AA
OBJECTIVES: To examine outcome after mindfulness training in a heterogeneous psychiatric outpatient population and to compare outcome in different diagnostic groups.
METHOD: One hundred and forty-three patients in 5 diagnostic categories completed questionnaires about psychological symptoms, quality of life, and mindfulness skills prior to and immediately after treatment.
RESULTS: The mixed patient group as a whole improved significantly on all outcome measures. Differential improvement was found for different diagnostic categories with respect to psychological symptoms and quality of life: Bipolar patients did not improve significantly on these measures. This finding could be explained by longer illness duration and lower baseline severity in the bipolar category.
CONCLUSION: Mindfulness training is associated with overall improvement in a heterogeneous outpatient population. Differences in outcome between diagnostic categories may be ascribed to differences in illness duration and baseline severity.
PMID: 23801545 [PubMed - indexed for MEDLINE]
A critical reanalysis of the relationship between genomics and well-being.
Proc Natl Acad Sci U S A. 2014 Aug 25;
Authors: Brown NJ, MacDonald DA, Samanta MP, Friedman HL, Coyne JC
Fredrickson et al. [Fredrickson BL, et al. (2013) Proc Natl Acad Sci USA 110(33):13684-13689] claimed to have observed significant differences in gene expression related to hedonic and eudaimonic dimensions of well-being. Having closely examined both their claims and their data, we draw substantially different conclusions. After identifying some important conceptual and methodological flaws in their argument, we report the results of a series of reanalyses of their dataset. We first applied a variety of exploratory and confirmatory factor analysis techniques to their self-reported well-being data. A number of plausible factor solutions emerged, but none of these corresponded to Fredrickson et al.’s claimed hedonic and eudaimonic dimensions. We next examined the regression analyses that purportedly yielded distinct differential profiles of gene expression associated with the two well-being dimensions. Using the best-fitting two-factor solution that we identified, we obtained effects almost twice as large as those found by Fredrickson et al. using their questionable hedonic and eudaimonic factors. Next, we conducted regression analyses for all possible two-factor solutions of the psychometric data; we found that 69.2% of these gave statistically significant results for both factors, whereas only 0.25% would be expected to do so if the regression process was really able to identify independent differential gene expression effects. Finally, we replaced Fredrickson et al.’s psychometric data with random numbers and continued to find very large numbers of apparently statistically significant effects. We conclude that Fredrickson et al.’s widely publicized claims about the effects of different dimensions of well-being on health-related gene expression are merely artifacts of dubious analyses and erroneous methodology.
PMID: 25157145 [PubMed - as supplied by publisher]
Depression screening and patient outcomes in pregnancy or postpartum: a systematic review.
J Psychosom Res. 2014 Jun;76(6):433-46
Authors: Thombs BD, Arthurs E, Coronado-Montoya S, Roseman M, Delisle VC, Leavens A, Levis B, Azoulay L, Smith C, Ciofani L, Coyne JC, Feeley N, Gilbody S, Schinazi J, Stewart DE, Zelkowitz P
OBJECTIVE: Clinical practice guidelines disagree on whether health care professionals should screen women for depression during pregnancy or postpartum. The objective of this systematic review was to determine whether depression screening improves depression outcomes among women during pregnancy or the postpartum period.
METHODS: Searches included the CINAHL, EMBASE, ISI, MEDLINE, and PsycINFO databases through April 1, 2013; manual journal searches; reference list reviews; citation tracking of included articles; and trial registry reviews. RCTs in any language that compared depression outcomes between women during pregnancy or postpartum randomized to undergo depression screening versus women not screened were eligible.
RESULTS: There were 9,242 unique titles/abstracts and 15 full-text articles reviewed. Only 1 RCT of screening postpartum was included, but none during pregnancy. The eligible postpartum study evaluated screening in mothers in Hong Kong with 2-month-old babies (N=462) and reported a standardized mean difference for symptoms of depression at 6 months postpartum of 0.34 (95% confidence interval=0.15 to 0.52, P<0.001). Standardized mean difference per 44 additional women treated in the intervention trial arm compared to the non-screening arm was approximately 1.8. Risk of bias was high, however, because the status of outcome measures was changed post-hoc and because the reported effect size per woman treated was 6-7 times the effect sizes reported in comparable depression care interventions.
CONCLUSION: There is currently no evidence from any well-designed and conducted RCT that screening for depression would benefit women in pregnancy or postpartum. Existing guidelines that recommend depression screening during pregnancy or postpartum should be re-considered.
PMID: 24840137 [PubMed - indexed for MEDLINE]
Prevalence of posttraumatic stress disorder (PTSD) in women with breast cancer.
J Psychosom Res. 2014 Jun;76(6):485-6
Authors: Kwakkenbos L, Coyne JC, Thombs BD
PMID: 24840144 [PubMed - indexed for MEDLINE]