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Biomedical subjects

M A Andrykowski

Publications and source records attributed to M A Andrykowski.

At least 55 records · Page 3Linked to original sources
PubMed1990

Development of learned food aversions in humans: investigation in a "natural laboratory" of cancer chemotherapy.

Humans often develop learned food aversions (LFAs) to foods or beverages consumed in temporal contiguity to gastrointestinal distress. Viewed as a classical conditioning process, principles of LFA development have been studied in the animal laboratory. Cancer chemotherapy provides a "natural laboratory" for examining whether these principles characterize human LFA development. Chemotherapy patients (n = 63) were interviewed prior to a regularly scheduled chemotherapy infusion (i.e. target infusion). Foods and beverages consumed in the preceding 24 h were identified. Postinfusion nausea and vomiting (PNV) was assessed. Finally, preference changes for items consumed prior to the target infusion were assessed prior to patients' next chemotherapy infusion. Contrary to hypothesis, (a) less preferred and familiar items were not more likely to become LFA targets, (b) LFA items were not consumed in close temporal contiguity to either the initiation of chemotherapy or PNV, and (c) LFAs developed in the absence of PNV. Consistent with the hypothesis, the severity of PNV was associated with a greater likelihood of LFA development. Problems in defining LFAs under non-experimental conditions are discussed as are the implications of results for the classical conditioning model of human LFA development.

Aged↗
PubMed1990

The quality of life in adult survivors of allogeneic bone marrow transplantation. Correlates and comparison with matched renal transplant recipients.

Research on the quality of life (QOL) following bone marrow transplantation has been hampered by assessment of a limited range of QOL domains as well as by a failure to assess relevant comparison groups. The QOL of adult survivors (n=29) of allogeneic BMT (mean of 51 months post-BMT) drawn from two BMT centers was assessed. QOL was also assessed in a sample of renal transplantation (RT) patients (n=29) matched with BMT patients with regard to age, sex, and time since transplant. Results indicated few differences between the BMT and RT groups across a broad range of QOL domains. Overall, neither group reported what might be considered a "normal" QOL. Multivariate analysis of the correlates of post-BMT QOL revealed that (1) less education, increased dosage of total-body irradiation during pre-BMT conditioning, and an older age at BMT were all associated with poorer status on several measures of post-BMT QOL; (2) time post-BMT was unrelated to post-BMT QOL; and (3) post-BMT affective status was more difficult to predict than post-BMT health or functional status. It was concluded that, while results indicate an acceptable post-BMT QOL, further research is necessary to identify means by which post-BMT QOL can be improved.

Adolescent↗
PubMed1990

Cognitive dysfunction in adult survivors of allogeneic marrow transplantation: relationship to dose of total body irradiation.

Bone marrow transplant (BMT) patients are exposed to several potential sources of neurologic damage including the neurotoxicity of pre-BMT preparative regimens. The latter generally include a combination of total body irradiation (TBI) and high-dose chemotherapy. Cognitive functioning in 30 adult allogeneic BMT patients (mean of 47 months post-BMT) treated for either acute or chronic leukemia was assessed by two standardized self-report questionnaires. Consistent with hypothesis, results of both univariate and multivariate analyses indicated that increased dose of TBI was associated with increased cognitive dysfunction. Furthermore, this relationship remained even after the impact of psychological distress upon cognitive functioning was accounted for. TBI-related cognitive impairment primarily involved slowed reaction time, reduced attention and concentration, and difficulties in reasoning and problem-solving. These results complement previous findings of an inverse association between dose of TBI and self-perceptions of health and physical functioning in BMT survivors and indicate the importance of including quality of life measures in clinical trials of therapeutic innovations in the field of BMT.

Adolescent↗
PubMed1989

Physical and psychosocial functioning of adult survivors of allogeneic bone marrow transplantation.

While prospects for long-term survival following bone marrow transplantation (BMT) have increased, little is known about the quality of that survival. The present study was intended to document the physical and psychosocial functioning of survivors of allogeneic BMT as well as identify factors associated with variability in post-BMT functioning. Twenty-three patients who were living at home and were between 3 and 52 months post-BMT completed the Functional Living Index - Cancer and the Profile of Mood States. Results revealed that current functioning varied considerably across patients. The older a patient was at time of transplant, the poorer his current functioning was, particularly in the physical domain. Current functioning was not significantly associated with time since transplant, the diagnosis of acute or chronic graft-versus-host disease, or dose of total body irradiation given as part of BMT conditioning. Despite differences in functional status, however, only one patient indicated that he would not make the same choice again to undergo BMT. Information about the long-term functioning of BMT survivors is critical for the process of obtaining informed consent. Additionally, understanding of factors associated with variability in post-BMT functioning can increase the likelihood that patients will ultimately return to a normal, productive life.

Activities of Daily Living↗
PubMed1989

Longitudinal assessment of psychosocial functioning of adult survivors of allogeneic bone marrow transplantation.

Existing research regarding the psychosocial functioning of adult survivors of allogeneic bone marrow transplantation (BMT) indicates that many patients experience difficulties in a variety of functional domains. A critical issue which has remained unexamined concerns the extent to which functioning improves, remains static, or perhaps even deteriorates with the passage of time post-BMT. To address this issue, the psychosocial functioning of 16 adult allogeneic BMT patients was assessed via a set of questionnaires on three occasions following their transplant. The initial assessment occurred a mean of 28 months post-BMT while the third assessment was a mean of 52 months post-BMT. Consistent with previous cross-sectional research, results indicated that many BMT survivors experience some long-term difficulties in physical, occupational, emotional, and cognitive functioning. Results indicated little change in functioning with the passage of time, suggesting that most patients might achieve a ceiling level of functioning within a couple of years post-BMT. At that time, further recovery of psychosocial functioning is likely to be minimal. Results are discussed with respect to their implications for both the encouragement of realistic expectations for post-BMT functioning as well as the development of post-BMT rehabilitation programs.

Adult↗
PubMed1988

Prevalence, predictors, and course of anticipatory nausea in women receiving adjuvant chemotherapy for breast cancer.

Factors related to the prevalence, prediction, and course of anticipatory nausea (AN) in women (n = 77) receiving adjuvant chemotherapy for breast cancer were examined. Using a prospective longitudinal research design, patients were interviewed both before and after each chemotherapy infusion. Fifty-seven percent of the patients developed AN. These patients were characterized by more severe gastrointestinal side effects following the initial infusion and greater expectations for experiencing chemotherapy-related nausea. A more rapid development of AN was related to a history of experiencing nausea across a greater variety of situations, higher IV drug doses, and less infusion-related anxiety at the initial infusion. Although AN occurred intermittently across treatment sessions, severity was constant. Results provided strong support for the hypothesis that classical conditioning processes are instrumental in AN acquisition. The role of anxiety in the development of AN is considered as are clinical implications for the prevention of AN and recommendations for future research.

Adult↗
PubMed1988

Nonpharmacologic factors in the development of posttreatment nausea with adjuvant chemotherapy for breast cancer.

A prospective, longitudinal design was used to determine the role of nonpharmacologic factors in the development of posttreatment nausea (PTN). Forty-five women with no previous chemotherapy experience who were receiving a single regimen of adjuvant chemotherapy for breast cancer were interviewed before and after their first six infusions. Seventy-one percent of patients developed PTN. The PTN was related to the following: patients' physical status at the onset of treatment; heightened anxiety during infusions; susceptibility to nausea and vomiting after eating certain foods; and expectations of developing chemotherapy-related nausea. Anxiety during infusions, susceptibility to nausea and vomiting, and expectations of side effects also accounted for differences in the frequency, intensity, and severity of PTN. These findings offer strong support for the view that nonpharmacologic factors contribute to individual differences in gastrointestinal responses to chemotherapy.

Adult↗
PubMed1988

Defining anticipatory nausea and vomiting: differences among cancer chemotherapy patients who report pretreatment nausea.

It is important to distinguish patients whose reports of pretreatment nausea and vomiting reflect classically conditioned anticipatory nausea and vomiting (ANV) from those whose reports reflect the influence of other pharmacological and psychological factors. Therefore, Andrykowski (J. Behav. Med. 9: 33-41, 1986) has suggested that only patients who report pretreatment nausea on Day 1 of a chemotherapy cycle be considered to have developed ANV. As part of a prospective, longitudinal investigation of side effects associated with cancer chemotherapy, three groups of patients were identified: those who (a) never reported pretreatment nausea (noPTN), (b) reported pretreatment nausea but never prior to a Day 1 infusion (PTN), and (c) reported pretreatment nausea prior to a Day 1 infusion (PTND1). Discriminant analysis revealed that the PTN and noPTN groups did not differ, while both differed from the PTND1 group, particularly with respect to factors presumed to facilitate classical conditioning. The results justify excluding PTN patients from the criterion group of patients considered to have developed ANV.

Adult↗
PubMed1987

Do infusion-related tastes and odors facilitate the development of anticipatory nausea? A failure to support hypothesis.

Distinctive tastes and odors have been identified as potent nausea-eliciting stimuli in cancer chemotherapy patients who develop anticipatory nausea or vomiting (ANV). Based on the experimental research on illness-aversion learning and based on previous clinical research with chemotherapy patients, it was hypothesized that the presence of tastes and odors during infusions should increase the likelihood that a patient will subsequently develop ANV. Seventy-eight new chemotherapy outpatients were interviewed immediately following each of their infusions with regard to the experience of infusion-related tastes, odors, and body sensations. Results failed to support the hypothesis. The subsequent development of ANV was unrelated to reports of tastes and odors both during patients' initial two chemotherapy infusions and during the two infusions preceding their initial report of ANV. Furthermore, reports of tastes and odors were surprisingly infrequent relative to previous research. Methodological and environmental explanations for this difference in taste and odor prevalence are considered. It is concluded that, when present, infusion-related tastes and odors may indeed increase the likelihood of subsequent development of ANV. However, future research should examine the extent to which the physical characteristics of chemotherapy clinics might affect the prevalence of infusion-related tastes and odors.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Definitional issues in the study of anticipatory nausea in cancer chemotherapy.

Biobehavioral research investigating anticipatory nausea in cancer chemotherapy has been hampered by the lack of a consistent and conceptually defensible definition of this phenomenon. The most frequently employed definitions have failed to account for the possibility that reports of pretreatment nausea might be attributable to pharmacological factors. One possibility is to restrict the definition of anticipatory nausea to instances of nausea or vomiting experienced prior to a treatment on Day 1 of a new chemotherapy cycle. The impact of this and previous common definitions of anticipatory nausea on research addressing the issues of prevalence rates and characteristics associated with the development of anticipatory nausea is illustrated and discussed. Overall, researchers are encouraged to reduce inappropriate criterion group heterogeneity through careful consideration of how the presence or absence of anticipatory nausea is defined.

Antineoplastic Agents↗
PubMedDate not supplied

Reducing distress in cancer patients with an orientation program.

The purpose of this study was to test a brief orientation program for reducing anxiety, depressive symptoms, and overall distress in cancer patients at their initial clinic visit. One hundred and fifty consecutively referred patients seen in an oncology outpatient clinic were randomly assigned to an intervention or usual care control group. The intervention group received a clinic tour, general information about clinic operations, and a question and answer session with an oncology counselor. Outcome measures included the State-Trait Anxiety Inventory (STAI), the Brief Profile of Mood States (POMS), the Center for Epidemiologic Studies-Depression (CES-D) Scale, and an oncology clinic questionnaire which were administered at the initial clinic visit and follow-up. There were no statistically significant clinical or demographic differences between groups at initial assessment. At follow-up, the intervention group had lower state anxiety, lower overall distress, and fewer patients reporting depressive symptoms. Patients in the intervention group demonstrated significantly more knowledge about clinic operations and greater satisfaction with care. These data provide evidence that anxiety, distress and depressive symptoms can be reduced with an orientation program. This finding has particular relevance in the early stages of diagnosis where patients may suffer symptoms of anxiety and depression.

Adaptation, Psychological↗
PubMedDate not supplied

Stability and change in posttraumatic stress disorder symptoms following breast cancer treatment: a 1-year follow-up.

While some recent research has examined the prevalence and severity of posttraumatic stress disorder (PTSD)-like symptoms following cancer treatment, no research has examined temporal change or stability in these symptoms in cancer survivors. Female breast cancer survivors (n=46) participated in an initial telephone interview and a follow-up interview 12 months later. PTSD symptoms associated with breast cancer were assessed using the PTSD Checklist-Civilian version (PCLC). In general, PTSD symptoms in this population did not diminish over time. While group analyses indicated that PCLC-total and subscale scores were stable across the two assessments, analyses of PCLC scores indicated that many patients exhibited fairly large (>0.5 S.D.) increases and/or decreases in PCLC-total or subscale scores. Some evidence suggested that decreases in PCLC scores between the two study assessments were associated with greater social support and experience of fewer traumatic stressors prior to breast cancer diagnosis. Most significantly, the research suggested that women with greater PTSD symptoms at the initial interview were less likely to participate in the follow-up interview. Implications of this for research and clinical management of PTSD in this population are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Interest in learning of personal genetic risk for cancer: a general population survey.

BACKGROUND: Previous studies have reported high interest in genetic testing for risk for colon or breast-ovarian cancer. These studies, however, have used samples which might be atypical with regard to level of interest evident among the general U.S. population. METHODS: As part of an annual statewide telephone health survey, adults' (n = 649) interest in learning about their personal genetic predisposition for cancer was assessed. RESULTS: High levels of interest in learning about a personal genetic predisposition for cancer in general (87%) and breast cancer in particular (93%) were expressed. Logistic regression analysis indicated that lack of interest was associated with less education, minority status, and less performance of other health-protective behaviors. Only 53% of respondents reported their understanding of genetics was "good" or "excellent." CONCLUSION: While interest in learning of one's personal genetic predisposition for cancer was high, many individuals requesting testing may have a less than good understanding of genetics and the implications of test results. Furthermore, variables associated with lack of interest in learning about personal genetic risk for cancer in this study were similar to those which have been previously found to be associated with poor utilization of other cancer control activities such as breast or cervical cancer screening.

Adolescent↗