How to recognize and manage psychological distress in cancer patients

Psychological distress is common in cancer patients, however, it is often unrecognized and untreated. We aimed to identify barriers to cancer patients expressing their psychological concerns, and to recommend strategies to assist oncologists to elicit, recognize, and manage psychological distress in their patients. Medline, Psychlit, and the Cochrane databases were searched for articles relating to the detection of emotional distress in patients. Patients can provide verbal and non-verbal information about their emotional state. However, many patients may not reveal emotional issues as they believe it is not a doctor's role to help with their emotional concerns. Moreover, patients may normalize or somatize their feelings. Anxiety and depression can mimic physical symptoms of cancer or treatments, and consequently emotional distress may not be detected. Techniques such as active listening, using open questions and emotional words, responding appropriately to patients' emotional cues, and a patient-centred consulting style can assist in detection. Screening tools for psychological distress and patient question prompt sheets administered prior to the consultation can also be useful. In conclusion, the application of basic communication techniques enhances detection of patients' emotional concerns. Training oncologists in these techniques should improve the psychosocial care of cancer patients.

Somebody Else's heart inside me: A descriptive study of psychological problems after a heart transplantation

This Article does not have an abstract

Physical and psychological factors maintain long-term predictive capacity post-whiplash injury

Higher initial levels of pain and disability, older age, cold hyperalgesia, impaired sympathetic vasoconstriction and moderate post-traumatic stress symptoms have been shown to be associated with poor outcome 6 months following whiplash injury. This study prospectively investigated the predictive capacity of these variables at a long-term follow-up. Sixty-five of an initial cohort of 76 acutely injured whiplash participants were followed to 2-3 years post-accident. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds and brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK and IES) were measured. The outcome measure was Neck Disability Index (NDI) scores. Participants with ongoing moderate/severe symptoms at 2-3 years continued to manifest decreased ROM, increased EMG during cranio-cervical flexion, sensory hypersensitivity and elevated levels of psychological distress when compared to recovered participants and those with milder symptoms. The latter two groups showed only persistent deficits in cervical muscle recruitment patterns. Higher initial NDI scores (OR 1.00-1.1), older age (OR 1.00-1.13), cold hyperalgesia (OR 1.1-1.13) and post-traumatic stress symptoms (OR 1.03-1.2) remained significant predictors of poor outcome at long-term follow-up (r(2) = 0.56). The robustness of these physical and psychological factors suggests that their assessment in the acute stage following whiplash injury will be important. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Psychology in practice: Guidelines for the provision of psychological services for older adults

The practice of psychology covers the range of ages from conception through to the end of life and palliative care. Psychologists practice in a variety of roles, but the majority of these roles involve interactions with nonprofessionals of varying ages. These interactions are governed by codes of ethical practice, whether these are developed by the funding bodies for research activities, professional associations, or regulatory bodies. Ethical codes vary in their format and emphasis, but all have the protection of the public as a major purpose. Often there are special provisions in these codes for particular populations or circumstances. Here we describe the development of ethical guidelines for the practice of psychology with older adults in Australia and report on those guidelines and their supporting literature.

Effects of psychological contract breach on performance of IT employees: The mediating role of affective commitment

In this study, we investigated the relationships between psychological contract breach, affective commitment, and two types of employee performance (i.e. civic virtue behaviour and in-role performance). It was predicted that an experience of contract breach can severely hurt the affective commitment of the employees and this, in turn, results in poor in-role performance and less civic virtue behaviours. Results revealed that affective commitment had differential mediating effects on the two types of employee performance. That is, affective commitment mediated the relationship between breach and self-reported and supervisor-rated civic virtue, but not the relationship between breach and in-role performance.

Passion and psychological adjustment: A test of the person-environment fit hypothesis

Passion represents a strong inclination toward an activity that is important, liked, and in which significant time is invested. Although a harmonious passion is well integrated in one’s identity and is emitted willingly, obsessive passion is not well integrated and is emitted out of internal pressure. This study tested for the presence of a Passion × Environment fit interaction with respect to psychological adjustment. Elite hockey players (N = 233) who tried out for a team in a highly competitive league participated in this short-term longitudinal study. As hypothesized, being selected by the highly competitive leagues led to higher psychological adjustment than not being selected by such leagues. Two months later, an interaction revealed that among athletes who were playing in highly competitive leagues, obsessively passionate athletes reported higher psychological adjustment than did harmonious athletes. Conversely, among athletes playing in less competitive leagues, harmonious athletes reported higher psychological adjustment than did obsessive athletes.

The MMPI-2 Gender-Masculine and Gender-Feminine scales: Gender roles as predictors of psychological health in clinical patients

Previous research measuring various biosocial factors such as age, sex, and marital status has found them to be essentially unrelated to measures of psychological health. Recent empirical studies have revealed that personality constructs may be more significant than demographic variables in the prediction of psychological well-being. The present study assessed the personality constructs of masculinity and femininity and hypothesized that the Gender-Masculine ( GM) scale of the MMPI-2 would be more effective than the Gender-Feminine (GF) scale in predicting psychological well-being. This hypothesis stems from previous research that has indicated the dominance of the masculinity model. It is suggested that previous research supporting androgyny as a primary indicator of well-being was influenced by the masculinity component of this gender orientation. One hundred and seventy-seven psychiatric patients from Australia (N = 107) and Singapore ( N 5 70) completed the MMPI-2. Hierarchical multiple regression revealed significantly stronger masculinity effects, with significance achieved on measures of ego strength and low self-esteem. No significant relationship between psychological well-being and the GF variable was found. Similarly, androgyny did not add any further variance to the model when masculinity was controlled for. Overall, the results are consistent with an interpretation that GM is a better correlate of psychological well-being as compared to the GF scale.

Workplace familism and psychological contract breach in the Philippines

The present study addresses the call for theory-based investigations on workplace familism. It contributes to the literature by proposing and testing the moderating role of workplace familism between psychological contract breach and civic virtue behaviour. We surveyed 267 full-time employees and found main effects of both types of workplace familism (i.e. workplace organisational and workplace supervisor familism) and breach of relational obligations on civic virtue behaviour. Workplace supervisor familism also moderated the relationship between breach and civic virtue behaviour, with the negative relationship between breach and civic virtue behaviour stronger when workplace supervisor familism was high. This suggests that employees with a high level of workplace supervisor familism may feel a sense of betrayal and, therefore, respond more negatively to contract breach. Implications for practice and directions for future research are discussed.

No pain, no gain? Torture and ethics in the war on terror

Is the use of torture ever justified? This article argues that torture cannot be justified, even in so called ticking bomb cases, but that in such extreme situations it may be necessary. In those situations, judgements about whether the use of torture is legitimate must balance the imminence and gravity of the threat with the need to prevent future occurrences of torture and maintain a normative environment that is hostile to its use. The article begins by observing that the use of torture and/or cruel and degrading treatment has become a core component of the global war on terror. It tests the claim that the use of coercive interrogation techniques does not constitute torture, showing that similar arguments were levelled by both the British and French governments in relation to Northern Ireland and Algeria respectively and found wanting. It then evaluates and rejects Dershowitz's claim for the legalization of torture and the more limited claim that torture may be permissible in ticking bomb scenarios. In the final section, the article questions how we might maintain the prohibition on torture while acknowledging that it may be necessary in some hypothetical cases.