Biomedical subjects

A L Stanton

Publications and source records attributed to A L Stanton.

At least 19 recordsLinked to original sources

PubMed2001

Form or function? Part 1. Subjective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy.

BACKGROUND: Quality of life (QOL) after a diagnosis of cancer varies considerably across individuals. Treatment-related factors that predict QOL for women who are diagnosed with breast carcinoma require further specification. This study was designed to develop a measure of perceived aesthetic (e.g., breast shape) and functional status (e.g., pain, mobility) after breast-conserving surgical treatment (BCT) and radiotherapy, to examine the relations of these indicators with patient QOL, and to determine whether these relations varied as a function of diagnosis duration. METHODS: Women (n = 185 patients) who underwent BCT and radiotherapy for Stage 0-II disease for whom the diagnosis duration ranged from 3 months to 18 years completed assessments of background information, perceived cosmetic and functional treatment outcomes, and QOL. Medical data also were obtained from medical charts. RESULTS: The Breast Cancer Treatment Outcome Scale (BCTOS) produced a coherent factor structure and three internally consistent subscales (i.e., cosmetic status, functional status, and breast specific pain) that demonstrated predictive validity. With patient age, diagnosis duration, and other BCTOS subscales controlled, greater breast specific pain predicted greater depressive symptoms (P < 0.01) and lower QOL related to mental health (P < 0.05) and physical health (P < 0.05). Cosmetic status predicted QOL related to physical health (P < 0.05). The relations of breast specific pain with QOL indicators varied somewhat as a function of diagnosis duration. CONCLUSIONS: Although considerable research on treatment-relevant outcomes has addressed appearance-related concerns, functional parameters have not been explored fully. Findings suggest that functional consequences of treatment, and particularly breast specific pain, also are significant influences on patient QOL.

Breast Neoplasms↗

PubMed2001

Form or function? Part 2. Objective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy.

BACKGROUND: Treatment-related factors that influence quality of life (QOL) for women who are diagnosed with breast carcinoma require study. This study was designed to examine the convergent validity of objective and subjective indices of cosmetic and functional status after patients undergo breast-conserving treatment (BCT) and to test the relations of the objective indicators with QOL. METHODS: Women (n = 54 patients) who had received BCT and radiotherapy for Stage 0-II disease for whom the diagnosis duration ranged from 9 months to 18 years completed assessments of background information, perceived cosmetic and functional outcomes, and QOL. They also were administered a clinical breast examination, including objective ratings of arm edema and breast cosmesis. The patients were a subsample from the study reported by the authors in an accompanying article that is presented in this issue. RESULTS: The findings revealed positive cosmetic and functional treatment outcomes, such that 82% of patients had no or minimal arm edema, and 70% of patients evidenced good or excellent cosmetic results. Convergent validity was demonstrated for the objective and subjective assessments of cosmetic and functional treatment outcomes. In addition, women who had more arm edema reported poorer QOL with regard to depressive symptoms (P < 0.05) and fear of disease recurrence (P < 0.05). CONCLUSIONS: The findings from this study and those reported in the accompanying article reveal that functional treatment outcomes, such as arm edema and breast specific pain, are important correlates of QOL even many years after patients undergo BCT and radiotherapy. Both subjective and objective indicators of treatment outcomes are useful predictors of QOL.

Breast Neoplasms↗

PubMed2001

Physician-assisted dying: review of issues and roles for health psychologists.

The authors review the recent empirical and theoretical literature on physician-assisted dying (PAD) since implementation of the Oregon Death With Dignity Act (ODDA) in 1997. The authors provide a brief overview of end-of-life practices; consider ethical and practical issues regarding PAD; outline governments' acts and health care organizations' current codified principles regarding PAD, including the American Psychological Association's goal to increase the visibility of psychology in end-of-life issues; examine recent data pertinent to ODDA implementation and psychologists' attitudes regarding PAD; and outline potential roles for health psychologists responding to requests for PAD and implementing PAD (where it is legal). Health psychologists can assume at least 4 roles regarding PAD: (a) policy advocates, (b) educators, (c) practitioners, and (d) researchers.

Ethics, Medical↗

PubMed2001

Expectancy-value constructs and expectancy violation as predictors of exercise adherence in previously sedentary women.

This prospective study examined effects of expectancy of exercise benefits, value of benefits, expectancy violation, and self-efficacy (SE) on exercise behavior and study dropout in sedentary women (n=86). SE predicted exercise for study completers but did not predict study dropout. After 6 and 12 weeks, participants evidenced expectancy violations, particularly for fitness and weight. Initial value, expectancy, and Expectancy X Value did not predict exercise for study completers, but dropouts had higher initial positive expectancies than did completers. Expectancy violations produced in Weeks 1-6 did not predict exercise in Weeks 7-12 in study completers, but dropouts in Weeks 7-12 had higher expectancy violations for weight in Weeks 1-6 than did completers. Follow-up revealed that study dropouts stopped exercising. Identifying individuals with high initial expectancies and expectancy violations may improve health behavior intervention and research.

Adolescent↗

PubMed2000

Coping through emotional approach: scale construction and validation.

Four studies demonstrate the psychometric adequacy and validity of scales designed to assess coping through emotional approach. In separate undergraduate samples, exploratory and confirmatory factor analyses of dispositional (Study 1) and situational (Study 3) coping item sets yielded 2 distinct emotional approach coping factors: emotional processing (i.e., active attempts to acknowledge and understand emotions) and emotional expression. The 2 scales yielded high internal consistency and test-retest reliability, as well as convergent and discriminant validity. A study (Study 2) of young adults and their parents established the scales' interjudge reliabilities. Longitudinal (Study 3) and experimental (Study 4) research supported the predictive validity of the emotional approach coping scales with regard to adjustment to stressful encounters. Findings highlight the utility of functionalist theories of emotion as applied to coping theory.

Adaptation, Psychological↗

PubMed2000

Stress and reproduction: introduction to the special section.

This special section on stress and reproduction is devoted to an emerging frontier in interdisciplinary research that merits the attention of health psychologists. The majority of the studies concern the role of stress and emotion on birth outcomes such as low birth weight, fetal growth and preterm delivery, or mechanisms underlying these findings. The implications of this research extend from maternal and infant health to life-span development and adult health and mortality.

Female↗

PubMed2000

Emotionally expressive coping predicts psychological and physical adjustment to breast cancer.

This study tested the hypothesis that coping through emotional approach, which involves actively processing and expressing emotions, enhances adjustment and health status for breast cancer patients. Patients (n = 92) completed measures within 20 weeks following medical treatment and 3 months later. Women who, at study entry, coped through expressing emotions surrounding cancer had fewer medical appointments for cancer-related morbidities, enhanced physical health and vigor, and decreased distress during the next 3 months compared with those low in emotional expression, with age, other coping strategy scores, and initial levels on dependent variables (except medical visits) controlled statistically. Expressive coping also was related to improved quality of life for those who perceived their social contexts as highly receptive. Coping through emotional processing was related to one index of greater distress over time. Analyses including dispositional hope suggested that expressive coping may serve as a successful vehicle for goal pursuit.

Adaptation, Psychological↗

PubMed1999

Fostering ethical willingness: integrating emotional and contextual awareness with rational analysis.

Ethical dilemmas are inherently challenging. By definition, clinicians decide between conflicting principles of welfare and naturally confront competing pulls and inclinations. This investigation of students' responses to an ethical scenario highlights how emotions and concerns can interfere with willingness to implement ethical knowledge. Clear-cut rules are the exception in psychotherapy, and clinicians must judge ethical issues on the basis of the unique context of each case. As such, subjectivity and emotional involvement are essential tools for determining ethical action, but they must be integrated with rational analysis. Strategies for attending to influential emotions and contextual factors in order to mobilize ethical commitment are described.

Attitude of Health Personnel↗

PubMed1998

Treatment decision making and adjustment to breast cancer: a longitudinal study.

This study monitored women (N = 76) with breast cancer from diagnosis through 1 year, and tested constructs from subjective expected utility theory with regard to their ability to predict patients' choice of surgical treatment as well as psychological distress and well-being over time. Women's positive expectancies for the consequences of treatment generally were maintained in favorable perceptions of outcome in several realms (i.e., physician agreement, likelihood of cancer cure or recurrence, self-evaluation, likelihood of additional treatment, partner support for option, attractiveness to partner). Assessed before the surgical decision-making appointment, women's expectancies for consequences of the treatment options, along with age, correctly classified 94% of the sample with regard to election of mastectomy versus breast-conserving procedures. Calculated from the point of decision making to 3 months later, expectancy disconfirmations and value discrepancies concerning particular treatment consequences predicted psychological adjustment 3 months and 1 year after diagnosis.

Adaptation, Psychological↗

PubMed1997

Efficacy of emotion-focused and problem-focused group therapies for women with fertility problems.

Competing positions exist in the literature regarding whether problem-focused or emotion-focused coping is more useful when one confronts a chronic health-related problem. In this study, 29 infertile women, who on average had been attempting conception for almost 4 years, were assigned to six sessions of training in problem- or emotion-focused coping or to a no-treatment control condition. Problem-focused training produced improvements in general distress and infertility-specific well-being at treatment termination. However, emotion-focused training resulted in greater improvement at a 1-months, follow-up. Emotion-focused participants reported less depression and more infertility-specific well-being at 1 month than did controls. At 18 months, problem-focused group members were more likely to have a child than were other participants. Results argue for the efficacy of both emotion-directed and problem-focused interventions in women's adjustment to infertility.

Adaptation, Psychological↗

PubMed1994

Coping through emotional approach: problems of conceptualization and confounding.

Two studies supported hypotheses that (a) published scales tapping coping through processing and expressing emotion are confounded with psychopathology; (b) previously demonstrated relations between emotional approach coping (EAC) and maladjustment are partially spurious; and (c) EAC, when tapped by items uncontaminated by distress, is beneficial under specific conditions. In Study 1, 194 psychologists rated a majority of published items, but no author-constructed EAC item, as indicative of pathology. Study 2 assessed relations of confounded and unconfounded EAC scales to 171 young adults' adjustment during stressful events. Confounded items evidenced weaker discriminant validity with distress measures than did unconfounded items, and they were weaker predictors of later maladjustment when initial adjustment was controlled than when it was not. Unconfounded EAC predicted improved adjustment for women and poorer adjustment for men over time.

Adaptation, Psychological↗

PubMed1993

Coping with a breast cancer diagnosis: a prospective study.

Employing the stress and coping theory of Lazarus and Folkman, this study followed 117 women age 40 or over regarding personality, cognitive appraisal, coping, and mood variables before breast biopsy, after diagnosis, and, for those who had cancer, after surgery. Upon biopsy, 36 received a cancer diagnosis, and 81 received a benign diagnosis. The 2 groups did not differ on appraisals, coping, or affect before diagnosis. With prebiopsy affect controlled, cancer patients reported more negative affect postbiopsy than did benign patients. Postsurgery, cancer patients expressed less vigor and more fatigue than benign patients, but the groups did not differ on other negative emotions. Prebiopsy, psychosocial predictors accounted for 54% and 29% of the variance in negative and positive emotion, respectively. Prebiopsy variables also predicted postbiopsy and postsurgery mood; cognitive avoidance coping was a particularly important predictor of high distress and low vigor.

Adaptation, Psychological↗

PubMed1993

Evaluation of relapse prevention and reinforcement interventions to promote exercise adherence in sedentary females.

An experimental design was employed to assess the effectiveness of a relapse prevention program, a reinforcement program, and an exercise-only control group in increasing exercise program adherence and short-term maintenance in 120 previously sedentary female university employees. The subjects participated in an 18-week exercise program composed of stretching, calisthenics, and aerobic dance. Attendance during the first half of the program was significantly higher for subjects in the relapse prevention group than for those in the control group. A nonsignificant trend in this direction emerged during the second half of the program and at 2-month follow-up. For all treatment groups, attrition (attendance at less than two thirds of the exercise sessions) was substantial, averaging 72% at the end of the 18-week program. These findings indicate that relapse prevention and reinforcement programs may not assist previously sedentary females in long-term adherence to an exercise program.

Adaptation, Psychological↗

PubMed1991

Influence of personality attributes and daily moods on bulimic eating patterns.

Relationships among personality attributes, mood states, and eating patterns were examined in a nonclinical sample of females with bulimic symptomatology and binge eaters. Thirteen subjects in each group completed trait measures of depression, anxiety, hostility, and locus of control. Subsequently, they self-monitored affect and eating patterns over a 20-day period. Greater state depression, anxiety, and hostility all were associated significantly with subsequent daily binge eating, and with purging for bulimic subjects. The association of binge occurrence with state anxiety and hostility was significantly greater for bulimics than for binge eaters. Locus of control and trait hostility were important in influencing reactivity of binge eating to daily moods. As trait hostility and externality increased, reactivity of binges to negative mood states also increased.

Adult↗

PubMed1991

A critical review of the Reasons for Smoking Scale.

The present article reviews studies bearing on the psychometric characteristics and clinical utility of the Reasons for Smoking Scale (RFS). It is concluded that the instrument possesses adequate psychometric properties such as a stable factor structure, internal consistency, and temporal stability. However, the supportive results of validity studies are weak and inconsistent. Moreover, the instrument appears to possess little clinical utility. Consequently, there exists little empirical evidence to justify its widespread use in clinical practice.

Humans↗

PubMed1991

Preparation of children for emergency medical care: a primary prevention approach.

Increased emergency room use and the resulting rise in pediatric visits have prompted interest in psychological aspects of pediatric emergency care. This study evaluated the efficacy of a multicomponent hospital program designed to prepare children for emergency room visits. In Phase 1, 148 kindergarteners completed measures of medical fears and knowledge at pretreatment, posttreatment, and a 4-week follow-up. Program attenders had significantly fewer medical fears and higher medical knowledge at posttest and follow-up than control children. The program was more effective for black than white children. In Phase 2, 51 high-fear children from Phase 1 were selected randomly to attend a medical examination in an emergency room. No effects for program emerged on the observational distress measures or physiological arousal. Phase 2 children showed significantly increased medical knowledge at follow-up compared to children who did not receive the medical exam.

Child, Preschool↗

PubMed1991

Cognitive appraisal and adjustment to infertility.

We examine adults' cognitive appraisals of their infertility and how these appraisals relate to each other and to psychological adjustment. In two samples, 76 women and 54 men rated their appraisals of threat, challenge, and control connected with infertility and completed measures of global and infertility-specific distress. Couples appraised their infertility as both harmful and beneficial, and as relatively uncontrollable. Partners did not differ in their appraisals or global distress, although wives reported more infertility-specific distress than their husbands. Women who were more threatened by their infertility were more distressed, as were those who felt less challenged and those who perceived less control over infertility outcomes. Males' appraisals were unrelated to distress, although men whose wives were more challenged by their impaired fertility were less distressed than their counterparts.

Adaptation, Psychological↗

PubMed1990

Assessment of the validity of the Reasons for Smoking scale.

To assess the convergent validity of the Reasons for Smoking scale (RFS) 30 male and 24 female smokers completed the RFS and then self-monitored their smoking motives over seven days. Significant validity coefficients, ranging from .39 to .51, were obtained for the stimulation, pleasure, habit, and psychological addiction motive scales. The stimulation, habit, and psychological addiction scales also demonstrated sound discriminant validity. Validity coefficients for the sensorimotor manipulation and negative affect reduction motive scales were nonsignificant. These results contrast sharply with the less positive findings of previous research. Sample and methodological differences between the studies may explain the dissimilarity in results.

Adult↗