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Byline: Chanita Hughes Halbert (1), Marc D. Schwartz (2), Lari Wenzel (3), Steven Narod (4), Beth N. Peshkin (2), David Cella (5), Caryn Lerman (6) Keywords: perceptions of stress and confidence; genetic testing; BRCA1 and BRCA2 Abstract: The objectives of this study were (1) to describe perceptions of stress and confidence following genetic testing for BRCA1 and BRCA2 (BRCA1/2) mutations and (2) to identify predictors of these processes. Participants were 130 high-risk women affected with cancer who received BRCA1/2 test results. Individual difference characteristics and interpersonal factors were measured by self-report before genetic counseling and perceptions of stress and confidence were evaluated by self-report 1 month following disclosure of test results. BRCA1/2 test results had a significant effect only on perceptions of stress ([beta] = 0.38, p = 0.0001), while trait anxiety had a significant effect on both perceptions of stress ([beta] = 0.44, p = 0.0001) and confidence ([beta] = -0.41, p = 0.001). These results suggest that interventions designed to address perceptions of stress related to medical decision-making and familial concerns may need to be targeted to BRCA1/2 mutation carriers and individuals who are highly anxious. Author Affiliation: (1) Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA (2) Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA (3) Department of Medicine, Epidemiology Division, University of California -- Irvine, Irvine, California, USA (4) The Centre for Research in Women's Health, Women's College Hospital, Toronto, Canada (5) Center on Outcomes, Research and Education, Northwestern University, Evanston, Illinois, USA (6) Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA Article History: Registration Date: 29/12/2004

Byline: Marc D. Schwartz (1), Kathryn L. Taylor (1), Kristen S. Willard (1) Keywords: mammography; high risk; distress; adherence Abstract: In this study we sought to evaluate the prospective association between psychological distress and mammography utilization among women with a family history of breast cancer. We evaluated the association of cancer worry, cancer-specific distress, and general distress with mammography utilization after controlling for potential confounders. The results revealed that 74% of our sample had obtained a mammogram within 12 months of the baseline assessment. Logistic regression models revealed that after controlling for potential confounding variables, cancer worry and general distress were independent predictors of mammography utilization. Specifically, women who reported higher levels of worry and/or distress at baseline were less likely to report having received a mammogram in the 12 months following the baseline assessment. These results are in contrast to the only other prospective study in this population. Additional research is needed to determine the prospective association between distress and adherence and to identify potential mechanisms for such an association. Author Affiliation: (1) Lombardi Cancer Center and Georgetown University School of Medicine, Washington, District of Columbia Article History: Registration Date: 05/10/2004

It is expected that prostate cancer will be diagnosed in 198,100 men and will be responsible for 31,500 deaths in the United States in 2001. (1) Despite the significant disease […]

This article examines the relationship between coping styles, genetic testing results, and anxiety in women with an elevated risk of ovarian or breast cancer. Findings indicate that a high monitoring coping style and a positive test result for a genetic mutation related to cancer risk are associated with increased anxiety.

The authors have studied the emotional states of women who have used mammography because of their increased risk for breast cancer. Participants who had low conscientiousness tended to have negative associations with mammography, while more conscientious women experienced little distress when using mammography.

The recent identification of BRCA1, a breast cancer susceptibility gene, offers an unprecedented opportunity for high-risk individuals to learn whether they are genetically predisposed to develop breast or ovarian cancer. This study examined the relationships between psychological distress and use of BRCA1 testing by 149 high-risk individuals from hereditary cancer families. After a baseline assessment of demographics, objective risk, cancer-specific distress, and global distress (depressive symptoms), study participants were offered the opportunity to receive genetic counseling and to learn whether they carry a mutation in the BRCA1 gene. Overall, 58% of study participants requested BRCA1 test results, and 42% declined to learn their genetic status. After controlling for demographic factors and risk status, cancer-specific distress was significantly and positively related to BRCA1 test use, whereas global distress was unrelated to test use.

Epoxy-coated anchors used for stabilization of the dam at the Occoquan River, Virginia, exhibited more creep movement and seating losses than bare-wire strands due to a difference in the material's behavior. Epoxy-coated anchors have provided double corrosion protection to the dam. Studies conducted by Harza Engineering Co. show that the Post-Tensioning Institute criteria may be unsuitable for epoxy-coated filled strand since it is based on the bare-wire strand. Lift-off tests are the best method for a long-term evaluation of anchor performance.

This study investigated whether women undergoing outpatient chemotherapy for breast cancer can develop classically conditioned emotional distress. Women scheduled to begin chemotherapy were randomly assigned either to an experimental group (exposed to a distinctive stimulus before each chemotherapy infusion) or a control group. After repeated infusions of chemotherapy, patients' responses to the distinctive stimulus were assessed in a location not associated with chemotherapy administration. At the test trial, experimental group patients showed evidence of increased emotional distress (self-reported on a visual analog scale) after the presentation of the distinctive stimulus, whereas control group patients did not. Post hoc analyses indicated that these increases in distress were not secondary to other conditioned responses (e.g., nausea, taste aversion). Thus, results supported the hypothesis that the pairing of a distinctive stimulus with chemotherapy would result in the development of a conditioned emotional response.

Patients receiving emetogenic chemotherapy for cancer have been found to develop aversions to normal dietary items consumed in close temporal relation to treatment administrations. These aversions are presumed to develop via conditioning processes as demonstrated in experimental studies of food aversion learning. The present study used a prospective, longitudinal design to evaluate the possible role of conditioning in the formation of aversions to normal dietary items in women receiving adjuvant chemotherapy for breast cancer. Patients were monitored for the development of aversions to foods and beverages consumed in the 24 hr periods before and after each of eight consecutive chemotherapy infusions beginning with the initial infusion. Data on the prevalence, course, and prediction of aversions to normal dietary items are reported. These results pointed to similarities and differences between aversions formed to normal dietary items during chemotherapy treatment and aversions formed to taste stimuli during experimental conditioning studies. In addition to their theoretical significance, results also suggest possible strategies for preventing the clinical problem of aversions to normal dietary items in chemotherapy patients.

Background As BRCA1/2 testing becomes more routine, questions remain about long-term satisfaction and quality of life following testing. Previously, we described long term distress and risk management outcomes among women with BRCA1/2 mutations. This study addresses positive psychological outcomes in BRCA1/2 carriers, describing decision satisfaction and quality of life in the years following testing. Methods We evaluated satisfaction with testing and management decisions among 144 BRCA1/2 carriers. Prior to genetic testing, we assessed family history, sociodemographics and distress. At a mean of 5.3 years post-testing, we assessed management decisions, satisfaction with decisions and, among women with cancer, quality of life. Results Overall, satisfaction with decision making was high. Women who had risk reducing mastectomy or oophorectomy were more satisfied with management decisions. Participants who obtained a risk reducing oophorectomy were more satisfied with their genetic testing decision. Among affected carriers, high pretest anxiety was associated with poorer quality of life and having had risk reducing mastectomy prior to testing was associated with better quality of life. The negative impact of pre-test anxiety was diminished among women who had mastectomies before testing. Conclusions BRCA1/2 carriers are satisfied with their testing and risk management decisions and report good quality of life years after testing. Having risk reducing surgery predicts increased satisfaction and improved quality of life. Keywords: BRCA1/2, Decision making, Satisfaction, Quality of life, Author(s): Gillian W Hooker[sup.3] , Lesley King[sup.4] , Lauren VanHusen[sup.1] , Kristi Graves[sup.1] , Beth N Peshkin[sup.1] , Claudine Isaacs[sup.2] , Kathryn L Taylor[sup.5] , Elizabeth Poggi[sup.1] and Marc D [...]

Objectives. We evaluated the impact of individualized breast cancer risk counseling on mammography use among women at risk for breast cancer. Methods. Participants (n = 508) were randomized to the breast cancer risk counseling intervention or a general health education control intervention, and 85% completed follow-up. Results. In multivariate modeling, a significant group-by-education interaction demonstrated that among less-educated participants, breast cancer risk counseling led to reduced mammography use. There was no intervention effect among the more-educated participants. Conclusions. These results suggest that standard breast cancer risk counseling could have an adverse impact on the health behaviors of less-educated women. (Am J Public Health. 1999;89:924-926)