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Endometriosis is a chronic systemic disease affecting 1 in 10 people assigned female at birth, that can result in appearance-based and functional bodily changes which can negatively impact body image. Empirical evidence supports the body dissatisfaction-driven hypothesis that negative body image leads to greater depressive symptoms; but potential underlying mechanisms are under-researched. This prospective study investigated the mediating role of two theoretically-derived intervening factors, self-esteem and rumination, in individuals living with endometriosis who typically report high rates of body image concerns and depressive symptoms. Initially, 996 participants completed the first online survey (T0) assessing demographic, medical and psychological factors. Of these, 451 completed surveys at 1-month (T1) and 2-months (T2) follow-up assessing self-esteem, rumination and depression. Bootstrapped analyses with full-information maximum likelihood estimation indicated that poor body image (T0) predicted greater depressive symptoms over time (T2). Self-esteem (T1), but not rumination (T1), mediated the body image-depression relationship. These results provide support for the body dissatisfaction-driven hypothesis and further identify that self-esteem is a key meditating factor. This highlights the importance of addressing self-esteem in body image focused interventions. • Greater body image concerns predict depressive symptoms over time. • Self-esteem mediated the body image-depression relationship. • Brooding (rumination) did not mediate the body image-depression relationship. • Body image-focused interventions should target self-esteem. [ABSTRACT FROM AUTHOR]

This study aimed to describe the adaptation of a group cognitive rehabilitation program for prostate cancer survivors (PCS) via telehealth delivery using a codesign approach with PCS experiencing cancer-related cognitive impairment. The Theoretical Domains Framework (TDF) also informed the intervention development. Intervention development consisted of three steps: 1) Adapting an existing cancer-related cognitive rehabilitation program for PCS; 2) Conducting a codesign focus group workshop to gather feedback that was analyzed using a template approach; and 3) Incorporation of consumer feedback to refine the program for future piloting in PCS. Components of the finalized intervention were mapped onto the TDF domains. Six PCS were involved in the codesign focus group workshop, providing feedback on program structure, the topics and its order, and rehabilitation activities. A manualized four-week online group cognitive rehabilitation program titled "Promoting Cognitive Wellbeing in Prostate Cancer Survivors (ProCog)" was developed. Four sessions of 2-hours' duration were designed exploring: cognitive/brain functions; the impact of cancer treatments and ageing; the relationship between thoughts, feelings and behaviors; values-based goal-setting; and skills/strategies to manage fatigue and improve attention, memory, aspects of executive functioning, and emotional functioning. Consumer input and guidance from the TDF ensures a robust development process for the online ProCog intervention, designed for and with PCS experiencing cognitive difficulties. As an important initial step before piloting, this adaptation and development process ensures that ProCog addresses consumer needs and preferences and targets factors increasing behavior change. This research raises awareness of possible cancer-related cognitive impairments in prostate cancer survivors and strategies for rehabilitation. ProCog is an accessible online intervention that nurses can use to refer patients needing cognitive rehabilitation. [ABSTRACT FROM AUTHOR]

Diminished quality of life, inadequate support and social isolation are commonly experienced by individuals living with the chronic pain condition, endometriosis. We aimed to determine the feasibility and acceptability of EndoSMS , a psychologically-focused text message intervention designed to support individuals living with endometriosis. As part of a two-arm parallel pilot randomised controlled trial with waitlist control, the feasibility and acceptability of a brief (3-month) version of EndoSMS was assessed using a mixed methods approach. Feasibility data (uptake, attrition, text message delivery analytics) and user acceptability (via self-report survey items and written feedback) were assessed. Qualitative data were thematically analysed using the template approach. Primary trial outcomes are not reported in this paper. Feasibility was indicated by: high conversion rate (99.1 %), low attrition (14.2 %), few opt-outs (0.02 %) and a high message delivery rate (99.8 %). Most intervention participants indicated user acceptability (mean = 4.02/5) across self-report questions. Most rated the length of the program (65.5 %), and the number (80.9 %) and language (94.5 %) of the text messages to be 'just right'. Thematic analysis created four themes: A shared "battle": Feeling less isolated and alone; "Be kind to yourself": A focus on self-care, self-compassion and active coping; Keeping endometriosis at the forefront: Helpful or stressful?; Mixed perceptions surrounding the provision of general endometriosis information; and, Tailoring of text messages. EndoSMS supportive text message program was feasible and acceptable for individuals with endometriosis. Future developments of the program should consider greater tailoring of content to user needs. Trial Registration : Australian New Zealand Clinical Trials Registry (ACTRN12621001642875). • EndoSMS text messaging aims to support individuals living with endometriosis. • A pilot RCT demonstrated very high feasibility and user acceptability of EndoSMS. • EndoSMS was rated as being appealing, useful and easy to understand. • Many participants found EndoSMS provided support and motivated active coping. • EndoSMS may help address the service gap in supportive care in endometriosis. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) patients who are treated with mastectomy are frequently offered immediate breast reconstruction. This study aimed to assess decisional conflict in patients considering immediate breast reconstruction, and to identify factors associated with clinically significant decisional conflict (CSDC). Baseline data of a multicenter randomized controlled trial evaluating the impact of an online decision aid for BC patients considering immediate breast reconstruction after mastectomy were analyzed. Participants completed questionnaires assessing sociodemographic and clinical characteristics, decisional conflict and other patient-reported outcomes related to decision-making such as breast reconstruction preference, knowledge, information resources used, preferred involvement in decision-making, information coping style, and anxiety. Multivariable logistic regression analysis was performed to identify factors associated with CSDC (score > 37.5 on decisional conflict). Of the 250 participants, 68% experienced CSDC. Patients with a slight preference for breast reconstruction (odds ratio (OR) = 6.19, p <.01), with no preference for or against breast reconstruction (OR = 11.84, p <.01), and with a strong preference for no breast reconstruction (OR = 5.20, p <.05) were more likely to experience CSDC than patients with a strong preference for breast reconstruction. Furthermore, patients with more anxiety were more likely to experience CSDC (OR = 1.03, p =.01). A majority of BC patients who consider immediate breast reconstruction after mastectomy experience clinically significant decisional conflict. The findings emphasize the need for decision support, especially for patients who do not have a strong preference for breast reconstruction. • A majority of patients considering immediate breast reconstruction experience decisional conflict. • Patients without a strong preference for breast reconstruction are more likely to experience decisional conflict. • Patients with more anxiety are more likely to experience decisional conflict. [ABSTRACT FROM AUTHOR]

Objective: To characterize the sociodemographic and psychological profiles of participant groups involved in altruistic surrogacy in Australia.Design: Cross-sectional study.Setting: Single psychological practice in Sydney, Australia.Patient(s): Six hundred and two individuals involved in 160 altruistic surrogacy arrangements: 143 intended mothers, 175 intended fathers (including 17 same-sex intended father couples), 160 surrogates, and 124 surrogate partners.Intervention(s): None.Main Outcome Measure(s): Responses to a presurrogacy sociodemographic assessment counseling protocol and the Personality Assessment Inventory (PAI).Result(s): The surrogates were primarily sisters, sisters-in-law, mothers (48.6%), or other extended family or friends (46.3%) of the intended parents. Most participants resided in residential postcode areas within the highest socioeconomic status quintile; however, intended mothers were more likely than surrogates to live in the most advantaged residential areas, to be younger and be more educated, and to be employed in professional occupations. Most participant psychological profiles were normal. A statistically significantly elevated PAI Somatic Complaints-Health Concerns subscale for intended mothers was observed compared with other participant groups. The higher PAI Warmth scale scores of intended mothers and surrogates were statistically significantly different from their respective partners, although not different from each other.Conclusion(s): Sociodemographic and some psychological differences between participant groups were observed that warrant exploration in pretreatment surrogacy counseling. Importantly, the higher scores on the PAI Warmth scale exhibited by intended mothers and surrogates in the context of close family and friendship relationships are likely to serve as protective mechanisms for the altruistic surrogacy outcome. [ABSTRACT FROM AUTHOR]

Abstract Objective This paper aims to systematically review and synthesize existing empirical evidence examining the factors related to interindividual differences in stressor appraisals (i.e., perceived challenge and threat). Method Studies were identified in PsycINFO, Scopus, Psychological and Behavioral Sciences Collection, and Medline databases (1980-March 2017). Only empirical studies assessing constructs theorized to influence stressor appraisals were included. Results Of the 1956 identified articles, 11 studies reported in 12 articles assessing six constructs met inclusion criteria: Emotional intelligence, Big Five personality traits, anxiety, stress mindset, just world beliefs, and perfectionism. Stronger challenge appraisals were associated with higher emotional intelligence, lower neuroticism, higher extraversion, and more positive beliefs about the consequences of feeling stressed. Weaker threat appraisals were associated with lower neuroticism, and higher emotional intelligence, agreeableness, extraversion, and openness, stronger beliefs that the world is a just and fair place, and lower perfectionistic concerns and greater perfectionistic striving. Anxiety was unrelated to appraisals. Conclusion This review identified factors associated with interindividual differences in stressor appraisals, with some factors related to challenge appraisal but not threat appraisal, and vice versa. This suggests a potentially complex interplay between personality and appraisals. Highlights • There are interindividual differences in the way stressful events are appraised. • This review collates factors related to these interindividual differences. • Eleven studies reporting on six different factors met inclusion criteria. • Very few of the identified factors have been replicated or confirmed. • Some factors related to challenge appraisal but not threat, and vice versa. [ABSTRACT FROM AUTHOR]

Background Decision-making concerning risk-reducing mastectomy for women at hereditary risk of breast cancer entails complex personal choices. Deciding whether and how to restore breast shape after risk-reducing mastectomy is a key part of this process. We developed a web-based decision aid, BRECONDA ( B reast Recon struction D ecision A id), to assist women in decision-making regarding breast reconstruction. Method This study assessed the efficacy of BRECONDA to assist women at increased risk of breast cancer in making decisions regarding risk-reducing mastectomy in terms of decisional conflict, knowledge, and satisfaction with information. Women at hereditary risk of breast cancer ( N = 64) were recruited into this randomized controlled trial from four Australian hereditary cancer clinics. Participants initially provided online consent and completed baseline questionnaires assessing decisional conflict, knowledge, and satisfaction with information. They were then randomly assigned to either: 1) Intervention – unlimited access to BRECONDA , with usual care; or, 2) Control – usual care. At 2-months follow-up ( N = 60) the outcomes were re-assessed. Intervention participants also completed user acceptability ratings for the intervention overall and specific key modules. Results MANCOVA analyses indicated that Intervention participants reported lower decisional conflict ( P = 0.027), and greater knowledge ( P = 0.019) and satisfaction with information ( P < 0.0005) at 2-months follow-up compared with Controls. Intervention participants reported high user acceptability and satisfaction with the intervention. Conclusion BRECONDA benefits women considering risk-reducing mastectomy by reducing decisional conflict, and improving knowledge and satisfaction with information. These benefits, coupled with high user acceptability, demonstrate the feasibility of implementing BRECONDA in the hereditary cancer risk context. [ABSTRACT FROM AUTHOR]

A high symptom burden systemic inflammatory disorder, endometriosis typically entails both medical management and self-management strategies. The COVID-19 pandemic in Australia precipitated changes to healthcare provision, societal restrictions, and negative psychosocial outcomes particularly for those managing chronic illnesses (e.g., endometriosis). This study's objective was to address the following questions: "How have endometriosis self-management strategies changed since the outbreak of COVID-19, and what are the consequences of these changes?" In total, 21 respondents residing in Australia during the COVID-19 pandemic participated in a semi-structured interview following completion of an online survey advertised by Endometriosis Australia. In the survey, respondents provided demographic and clinical information, and psychological distress was assessed. Interviews were conducted online and recorded for transcribing. Transcribed data were thematically analyzed using the template method. Qualitative analysis identified five themes: i) Maintaining Relationships with Health Professionals, ii) Altered Information Seeking Strategies, iii) More Autonomous Decision Making, iv) Diminished Self-Care and Behaviour Change, and v) Shifted Priorities. Respondents reported disruptions to, and uncertainties within, the healthcare system that precipitated adverse effects upon their ability to manage endometriosis and mental health. These findings suggest that for many, COVID-19-related disruptions to the healthcare system and social isolation adversely impacted their endometriosis self-management. Targeted interventions are needed to address the consequences of these, including providing reliable information to support informed decision-making regarding endometriosis self-management, and assisting with mental health challenges arising from COVID-19-related social isolation. • The COVID-19 pandemic demanded greater reliance on endometriosis self-management. • Reduced health professional contact increased focus on individual decision-making. • There was a corresponding reported reduction in self-care activities. • Avoidance of social situations is an ongoing concern for many with endometriosis. [ABSTRACT FROM AUTHOR]

Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema ( n = 11) or secondary lymphedema associated with gynecological cancer ( n = 8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available. [ABSTRACT FROM AUTHOR]

The association between stress beliefs and stressor appraisals has been limited by the absence of a comprehensive stress belief scale. This paper aimed to develop a new stress belief scale (the Subjective Thoughts REgarding Stress Scale; STRESS) and to assess the association between stress beliefs and stressor appraisals. Study 1: A pool of 75 Likert-type items assessing beliefs about stress and cognition, emotion, social factors, and behavior, was piloted on an international sample (N = 107); all items were found to reflect commonly held beliefs. Study 2: Exploratory factor analysis (N = 419), reduced the scale to 19 items over three factors (Consequences, Social Factors, and Coping Efficacy), demonstrating acceptable construct validity and internal reliability. Study 3: Confirmatory factor analysis (N = 300) replicated the factor structure in a new sample and demonstrated acceptable convergent and divergent validity. Study 4: Predictive validity (N = 137) was demonstrated with stressor appraisals and acceptable test-retest reliability over two weeks. This study provides evidence for both good psychometric properties of the new STRESS measure and predictive validity in terms of an association between stress beliefs and stressor appraisals. • Current stress belief measures do not correlate with stressor appraisals. • Current stress belief measures may have flaws in their development. • This four-study paper reports the development of a new measure, the STRESS. • The STRESS demonstrated satisfactory psychometric requirements. • The STRESS predicted five types of stressor appraisals of a stress induction. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To systematically review existing empirical evidence regarding the effectiveness of computerised decision aids (CDAs) in enabling high-quality decision-making in preference-sensitive health-related contexts. Methods: Relevant studies were identified via Medline, CINAHL, and PsycINFO databases (1990–October 2010). Only randomised controlled trials with at least one decision quality or decision process variable outcome were included. Results: Of 1467 identified articles, 28 studies met all inclusion criteria, evaluating 26 unique CDAs. CDAs performed better than standard consultations/education regarding improved knowledge and lower decisional conflict, and were found not to increase anxiety. CDAs facilitated greater satisfaction with the decision-making process than standard education. The effects on risk perceptions, value congruence with the chosen option, preferred roles in decision-making and decisional self-efficacy need further evaluation. A paucity of CDAs adhered to decision theories. Conclusions: CDAs showed similar effects as non-computerised DAs on various outcomes. Further research into the potentially superior effects of CDAs on feeling informed, values-clarity, and decisional conflict is required. Practice implications: The more remarkable effects on knowledge and risk perceptions were reported when unique features of interactive computerised media were used. The potential benefit of tailored information, values-clarification, and integration of CDAs into shared decision-making consultations remains unresolved. [Copyright &y& Elsevier]

Background & Aims: Although pouchitis is considered the most common adverse sequela of ileal pouch–anal anastomosis (IPAA), inflammatory and noninflammatory conditions other than pouchitis are increasingly being recognized. The risk factors for these non-pouchitis conditions, including Crohn’s disease (CD) of the pouch, cuffitis, and irritable pouch syndrome (IPS), have not been studied. The aim of this study was to assess risk factors for inflammatory and noninflammatory diseases of IPAA in a tertiary care setting. Methods: The study consisted of 240 consecutive patients who were classified as having healthy pouches (N = 49), pouchitis (N = 61), CD of the pouch (N = 39), cuffitis (N = 41), or IPS (N =50). Demographic and clinical features were assessed to determine risk factors for each of these conditions by using logistic regression analysis. Results: Risk factors remaining in the final logistic regression models were for pouchitis: IPAA indication for dysplasia (odds ratio [OR], 3.89; 95% confidence interval [CI], 1.69–8.98), never having smoked (OR, 5.09; 95% CI, 1.01–25.69), no use of anti-anxiety agents (OR, 5.19; 95% CI, 1.45–18.59), or use of NSAIDs (OR, 3.24; 95% CI, 1.71–6.13); for CD of the pouch: a long duration of IPAA (OR, 1.20; 95% CI, 1.12–1.30) and current smoking (OR, 4.77; 95% CI, 1.39–16.25); for cuffitis: arthralgias (OR, 4.13; 95% CI, 1.91–8.94) and younger age (OR, 1.16; 95% CI, 1.01–1.33); and for IPS: use of antidepressants (OR, 4.17, 95% CI, 1.95–8.92) or anti-anxiety agents (OR, 3.21; 95% CI, 1.34–7.47). Conclusions: The majority of risk factors for the 4 inflammatory and noninflammatory conditions of IPAA are different, suggesting that each of these diseases has a different etiology and pathogenesis. The identification and modification of these risk factors might help patients and clinicians to make a preoperative decision for IPAA, reduce IPAA-related morbidity, and improve response to treatment. [Copyright &y& Elsevier]

Growing evidence links adult attachment style, mindfulness, and emotion dysregulation with depression and anxiety. Little is known about the nature of association between these variables during the pregnancy, a period of significant stress. This cross-sectional study aimed to test associations between attachment style, mindfulness, emotion regulation and psychological distress during pregnancy, and delineate the relative contribution to maternal experiences of pregnancy-specific anxiety compared with general anxiety and depressive symptoms. Two-hundred and thirty-one pregnant women completed an online survey. Sociodemographic, pregnancy, health, and psychosocial variables were assessed using standard or validated, self-report measures. Mindfulness, emotion regulation and attachment anxiety contributed significant variance to each distress outcome; however, the model for pregnancy-specific anxiety accounted for less variance compared to depressive symptoms and general anxiety, suggesting that other factors may be important in the development of pregnancy-specific anxiety. Mindfulness, emotion regulation, and attachment style play an important role in maternal psychological wellbeing during pregnancy. Implications for screening and clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Objective: To assess consumer and health professional user acceptability of a web-based self-compassion writing activity to minimize psychological distress related to the negative impact of breast cancer on body image.Methods: "My Changed Body" is a web-based writing activity that combines expressive writing with a self-compassionate approach that focuses on cancer-related adverse body image alterations. Breast cancer survivors (n=15) and health professionals (n=20) provided feedback via a survey regarding the appearance, organization and content of the website and writing activity.Results: Both breast cancer survivors and health professionals rated the website highly in terms of design, layout and content. Participants commented positively on the website's clear wording, appealing design and ease of navigation. Suggestions for improving the website included simplifying the instructions for the writing activity and allowing participants' writing to be saved.Conclusion: Results from both breast cancer survivors and health professionals suggest a moderate to high level of user acceptability and positive ratings for the overall impression of the website.Practice Implications: Self-compassion based writing interventions can be translated to a web-based self-administered activity for body image difficulties after breast cancer treatment in a format that is acceptable to consumers and health professionals. [ABSTRACT FROM AUTHOR]