Biomedical subjects

Charles S Carver

Publications and source records attributed to Charles S Carver.

At least 19 recordsLinked to original sources

PubMed2007

Frequency and difficulty in caregiving among spouses of individuals with cancer: effects of adult attachment and gender.

How caregivers relate to care recipients can affect how well care is provided and how much burden is experienced in providing it. We conceptualized the relationship of spousal caregivers via adult attachment theory and examined how attachment qualities of caregivers related to level of caregiving involvement and difficulties in caregiving. Gender differences in the associations were also explored. From participants in the ACS Quality of Life Survey for Caregivers, 400 spousal caregivers provided valid data for the study variables. Findings indicated that frequency of various types of care was a joint function of attachment orientation and gender. In contrast, the difficulty that caregivers experienced in providing care related directly to attachment, without moderation by gender. Our findings suggest that ineffective caregivers of cancer patients, who can be identified by their attachment orientation and/or gender, may benefit from educational programs to improve their caregiving skills and to encourage them to utilize resources from other family members or community.

Attitude↗

PubMed2006

Relations of serotonin function to personality: current views and a key methodological issue.

Studies of biological underpinnings of personality suggest that serotonergic functioning relates to certain personality traits. However, how to interpret the findings depends partly on assumptions about how personality is organized. These assumptions are reflected in the assessment devices used and also in how the data are examined. Review of evidence to date appears to link serotonin function to impulsivity and, to some extent, to hostility. The relation of serotonin function to anxiety proneness is far more questionable. Indeed, when such a relation occurs, it often takes a form opposite to the direction argued by theory. It is recommended that research use measures that discriminate adequately among personality qualities reflecting incentive sensitivity, threat sensitivity, and impulsiveness. Indeed, it is highly desirable to examine facets of each of these qualities separately.

Anxiety↗

PubMed2006

Quality of life among long-term survivors of breast cancer: Different types of antecedents predict different classes of outcomes.

Quality of life (QOL) has many aspects, both in the short-term and in the long-term. Different aspects of QOL may have different types of precursors: demographic, medical, and psychosocial. We examined this possibility in a group of long-term breast cancer survivors. Early-stage breast cancer patients (N = 163) who had provided information about medical, demographic, and psychosocial variables during the year after surgery completed a multidimensional measure of QOL 5-13 years later. Initial chemotherapy and higher stage predicted greater financial problems and greater worry about appearance at follow-up. Being partnered at diagnosis predicted many psychosocial benefits at follow-up. Hispanic women reported greater distress and social avoidance at follow-up. Initial trait optimism predicted diverse aspects of better psychosocial QOL at follow-up, but not other aspects of QOL. Thus, different aspects of QOL at long-term follow-up had different antecedents. Overall, psychological outcomes were predicted by psychosocial variables, presence of a partner at diagnosis, and ethnicity. Financial outcomes, in contrast, were predicted by medical variables, which otherwise predicted little about long-term QOL. This divergence among aspects of QOL should receive closer attention in future work.

Adult↗

PubMed2006

A qualitative exploration of the cancer experience among long-term survivors: comparisons by cancer type, ethnicity, gender, and age.

BACKGROUND: To elucidate meanings ascribed to the cancer experience by long-term survivors. METHODS: Semi-structured interviews were conducted with 58 cancer survivors (>15 years post-diagnosis). Respondents described how cancer affected their quality of life (QOL) generally and in 17 domains. Systematic content analyses were conducted to extract themes relating to meanings assigned to the cancer experience. Themes were analyzed by cancer type, gender, and age and confirmed using quantitative assessments of self-rated health and QOL. RESULTS: Four themes were identified: Personal Growth, That's Life. Relinquishing Control, and Resentment. Women more frequently acknowledged Personal Growth, and men more often indicated minimal impact on their lives (That's Life). Older survivors were disproportionately classified as That's Life and younger survivors as Personal Growth. No differences were observed by cancer type or ethnicity. Those who saw cancer as personal growth had the highest QOL, while those who resented cancer had the lowest QOL. CONCLUSIONS: Most long-term survivors retrospectively report that cancer either positively influenced their lives or had little long-term impact. Those who express Resentment report that pain, physical deformities, and social isolation significantly reduced their QOL. This qualitative study highlights how cancer survivors incorporate the cancer experience within their overall lives.

Adult↗

PubMed2006

Anger suppression mediates the relationship between optimism and natural killer cell cytotoxicity in men treated for localized prostate cancer.

OBJECTIVE: This study evaluated relations among optimism, depression, anger suppression and natural killer cell cytotoxicity (NKCC) in 61 men treated for localized prostate cancer (PC). METHOD: All participants were assessed at a single time point where demographics, optimism, depression and anger suppression were measured. We also collected peripheral venous blood to assess NKCC. RESULTS: Results showed that greater optimism was associated with greater NKCC (beta=.27, P<.05), less depression (beta=-.63, P<.001) and less anger suppression (beta=-.29, P<.05). Furthermore, less anger suppression (beta=-.35, P<.01) was associated with greater NKCC. In a hierarchical regression model controlling for depression and then anger suppression, the relationship between optimism and NKCC became nonsignificant [beta=.18, t(56)=1.51, P=.14], while anger suppression remained significantly correlated with NKCC [beta=-.29, t(56)=-2.40, P<.05]. CONCLUSIONS: Results suggest that optimism is associated with NKCC and a greater ability to adaptively express anger. Furthermore, it appears that less anger suppression partially mediates the relationship between optimism and NKCC.

Aged↗

PubMed2006

Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer.

Two previously studied cohorts of women with nonmetastatic breast cancer (Ns = 230 and 136) were reexamined. Participants were assessed during the year after surgery and 5-8 years later. Associations were examined between benefit finding (BF) and several indicators of psychosocial adjustment (e.g., perceived quality of life, positive affect, negative affect, social disruption, and intrusive thoughts). Significant curvilinear relations between BF and other outcomes were observed cross-sectionally during initial assessment and at long-term follow-up in both samples. Compared with the intermediate BF group, low and high BF groups had better psychosocial adjustment. Further analyses indicated that the high BF group reported higher optimism and more use of positive reframing and religious coping than the other BF groups. Discussion highlights the need to examine nonlinear as well as linear relationships.

Adaptation, Psychological↗

PubMed2006

How stress management improves quality of life after treatment for breast cancer.

The range of effects of psychosocial interventions on quality of life among women with breast cancer remains uncertain. Furthermore, it is unclear which components of multimodal interventions account for such effects. To address these issues, the authors tested a 10-week group cognitive-behavioral stress management intervention among 199 women newly treated for nonmetastatic breast cancer, following them for 1 year after recruitment. The intervention reduced reports of social disruption and increased emotional well-being, positive states of mind, benefit finding, positive lifestyle change, and positive affect for up to 12 months (indeed, some effects strengthened over time). With respect to mechanisms tested, the intervention increased confidence in being able to relax at will. There was also evidence that effects of the intervention on the various outcomes examined were mediated by change in confidence about being able to relax. Thus, this intervention had beneficial effects on diverse aspects of quality of life after treatment for breast cancer, which appear linked to a specific stress management skill taught in the intervention.

Adaptation, Psychological↗

PubMed2006

Self-regulation processes and health: the importance of optimism and goal adjustment.

This article discusses how self-regulatory models can be used to understand people's response to health threats. The article begins with a general discussion of the principles and assumptions of self-regulatory models of behavior. Two distinct lines of research are then presented addressing two important processes of adaptive self-regulation. First, we provide a brief overview of the literature on optimism and adjustment to chronic disease and other health outcomes. Second, we present an overview of the process of disengagement from unattainable goals, focusing on recent research. We close by making recommendations for future research.

Attitude to Health↗

PubMed2006

Reduction of cancer-specific thought intrusions and anxiety symptoms with a stress management intervention among women undergoing treatment for breast cancer.

OBJECTIVE: After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention. METHOD: A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment. RESULTS: The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy. CONCLUSIONS: Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer.

Adaptation, Psychological↗

PubMed2005

Enhancing adaptation during treatment and the role of individual differences.

With increased effectiveness of medical treatment for cancer, greater attention has been directed to the quality of life of cancer patients and cancer survivors. Work on this topic is aimed at better understanding the determinants of quality of life and creating ways to optimize these outcomes. Insights from many disciplines inform this effort. For example, personality psychology suggests bases for naturally occurring differences in resilience but also suggests ways to enhance adaptation and promote greater resilience. The author's current work relies on a view of individuals as goal-seeking beings whose efforts toward desired outcomes are threatened by diagnosis and treatment of cancer. Some react to such adversity with increased efforts, others with a giving-up response. This difference promotes differences in emotional well being. The author's group is focused on enhancing adaptation and providing patients with skills for stress management that permit patients to remain engaged in the pursuits that form their lives. This stress-management intervention has reduced the prevalence of depression among breast cancer patients and has increased the extent to which they report positive sequelae from cancer. The latter effect also has been related to differential reduction in cortisol. Ongoing work is examining well being in longer term survivors, including the effects of this intervention and the possibility that the intervention will have positive consequences for physical health.

Adaptation, Psychological↗

PubMed2005

Assessing quality of life in adult cancer survivors (QLACS).

This article describes development of a quality of life measure designed to assess issues relevant to long-term cancer survivors. In-depth semi-structured interviews were conducted with 58 long-term cancer survivors to identify domains most relevant to long-term survivors (> or = 5 years post-diagnosis). Self-report items were developed from these interviews and administered to a second sample of 242 long-term survivors. Domains and items were selected from the item pool by a combination of factor analysis and criterion-based item selection. Five cancer-specific domains were identified (appearance concerns, financial problems, distress over recurrence, family-related distress, and benefits of cancer) along with seven generic QOL domains (negative feelings, positive feelings, cognitive problems, sexual problems, physical pain, fatigue, and social avoidance). Cronbach's alpha was 0.72 or greater for each domain. Correlations between domain scores and criterion measures were 0.72 or higher in all but one generic domain (social avoidance), but somewhat lower on cancer-specific domains. The new multidimensional measure has good internal consistency and validity and is appropriate for comparisons between cancer and non-cancer populations, as well as long-term follow-up of cancer patients.

Aged↗

PubMed2005

Perceived partner reactions to diagnosis and treatment of breast cancer: impact on psychosocial and psychosexual adjustment.

Two studies examined breast cancer patients' perceptions of their partners' reactions to their diagnosis and treatment as influences on 3 aspects of patients' well-being: psychosexual adjustment, emotional distress, and marital satisfaction. Study 1, cross-sectional, indicated that partner initiation of sex, frequency of sex, a positive 1st sexual experience after treatment, and especially perception of the partner's emotional involvement in the relationship, were relevant to these outcomes. Study 2, longitudinal, confirmed many of these findings in prospective tests across 1 year of recovery after surgery. Partner involvement prospectively predicted all 3 outcomes. Partner initiation of sex predicted greater marital satisfaction; partner adverse reaction to the scar predicted less marital satisfaction. Rated quality of the 1st sexual experience after treatment predicted less distress. The pattern suggests that women's impressions of their partners' emotional involvement after surgery for breast cancer forecast their adjustment in sexual, marital, and emotional arenas over the following year.

Adolescent↗

PubMed2005

Optimistic personality and psychosocial well-being during treatment predict psychosocial well-being among long-term survivors of breast cancer.

In considering well-being among survivors of life-threatening illnesses such as breast cancer, 2 important questions are whether there is continuity between initial adjustment and longer term adjustment and what role personality plays in long-term adjustment. In this research, a sample of 163 early stage breast cancer patients whose psychosocial adjustment was first assessed during the year after surgery completed the same measures 5-13 years after surgery. Initial reports of well-being were relatively strong predictors of follow-up well-being on the same measures. Initial optimism and marital status also predicted follow-up adjustment, even controlling for earlier adjustment, which exerted a substantial unique effect in multivariate analyses. In contrast, initial medical variables played virtually no predictive role. There is substantial continuity of subjective well-being across many years among survivors of breast cancer, rooted partly in personality and social connection.

Adaptation, Psychological↗

PubMed2005

Two distinct emotional experiences in romantic relationships: effects of perceptions regarding approach of intimacy and avoidance of conflict.

This study examined how perceived position and velocity regarding approach and avoidance in romantic relationships relate to affective experiences. The authors hypothesized that perceived progress toward intimacy would predict positive affect and that perceived movement toward conflict would predict anxious affect. Ninety-two romantic couples recorded perceived levels of, and perceived changes in, both intimacy and conflict twice daily throughout 10 consecutive days using electronic palm-top devices. Multilevel modeling demonstrated that perceived increase in intimacy related to positive affect above and beyond perceptions of intimacy, conflict, and changes in conflict, for both male and female partners. Perceived increase in conflict related to anxious affect above and beyond perceptions of conflict, intimacy, and changes in intimacy, but only among male partners. Findings support a dual-process view of these feelings in romantic relationships and suggest that increases in positive feelings in close relationships depend on enhancing intimacy rather than on decreasing conflict.

Adult↗

PubMed2005

Impulse and constraint: perspectives from personality psychology, convergence with theory in other areas, and potential for integration.

A behavioral dimension of impulse versus constraint has long been observed by personality psychologists. This article begins by reviewing processes underlying this dimension from the perspectives of several personality theories. Some cases of constraint reflect inhibition due to anxiety, but some theories suggest other roots for constraint. Theories from developmental psychology accommodate both possibilities by positing 2 sorts of control over action. These modes of influence strongly resemble those predicated in some personality theories and also 2 modes of function that are asserted by some cognitive and social psychological theories. Several further literatures are considered, to which 2-mode models seem to contribute meaningfully. The article closes by addressing questions raised by these ideas, including whether the issue of impulse versus constraint applies to avoidance as well as to approach.

Antisocial Personality Disorder↗

PubMed2004

Cognitive-behavioral stress management improves stress-management skills and quality of life in men recovering from treatment of prostate carcinoma.

BACKGROUND: The current study evaluated the efficacy of a 10-week, group-based, cognitive-behavioral stress management (CBSM) intervention relative to a half-day seminar in improving quality of life (QoL) among men who were treated for localized prostate carcinoma (PC) with either radical prostatectomy (RP) or radiation therapy. METHODS: Ninety-two men were assigned randomly to either the 10-week CBSM group intervention or a 1-day seminar (control group). The intervention was designed to improve QoL by helping participants to identify and effectively manage stressful experiences and was focused on the treatment-related sequelae of PC. RESULTS: A hierarchical regression model was used to predict postintervention QoL. The final model, including all predictors and relevant covariates (i.e., income, baseline QoL, ethnicity, and group condition), explained 62.1% of the variance in QoL scores. Group assignment was a significant predictor (beta = - 0.14; P = 0.03) of QoL after the 10-week intervention period, even after controlling for ethnicity, income, and baseline QoL. Post-hoc analyses revealed that individuals in the CBSM intervention condition showed significant improvements in QoL relative to men in the 1-day control seminar. Improved QoL was mediated by greater perceived stress-management skill. CONCLUSIONS: A 10-week cognitive-behavioral group intervention was effective in improving the QoL in men treated for PC, and these changes were associated significantly with intervention-associated increases in perceived stress-management skills.

Aged↗

PubMed2004

Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer.

OBJECTIVE: This study examined the effect of a cognitive-behavioral stress management (CBSM) intervention on emotional well-being and immune function among women in the months following surgery for early-stage breast cancer. METHOD: Twenty-nine women were randomly assigned to receive either a 10-week CBSM intervention (n=18) or a comparison experience (n=11). The primary psychological outcome measure was benefit finding. The primary immune function outcome measure was in vitro lymphocyte proliferative response to anti CD3. RESULTS: Women in the CBSM intervention reported greater perceptions of benefit from having breast cancer compared to the women in the comparison group. At 3-month follow-up, women in the CBSM group also had improved lymphocyte proliferation. Finally, increases in benefit finding after the 10-week intervention predicted increases in lymphocyte proliferation at the 3-month follow-up. CONCLUSION: A CBSM intervention for women with early-stage breast cancer facilitated positive emotional responses to their breast cancer experience in parallel with later improvement in cellular immune function.

Adult↗

PubMed2004

Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis.

Cancer patients experience positive as well as adverse consequences from diagnosis and treatment. The study reported here examined longer term reverberations of such experiences. A set of benefit-finding items along with measures of well-being were completed by 230 early-stage breast cancer patients in the year postsurgery. Four to 7 years later, 96 of them again completed measures of well-being. Controlling for initial distress and depression, initial benefit finding in this sample predicted lower distress and depression at follow-up.

Adaptation, Psychological↗