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Objective: Supportive-expressive (SE) group psychotherapy is designed to be applicable to medically ill populations. In this open trial, SE therapy was adapted for use in treating inflammatory bowel disease (IBD).Method: Thirty subjects with Crohn's disease (CD) or ulcerative colitis (UC) were enrolled in 4 psychotherapy groups. Each group met weekly for 20 weeks to discuss emotional and interpersonal issues associated with illness. Physical and psychological variables were measured at the onset and at the finish of the group sessions.Results: There was no mean group change in quality of life (QL), anxiety, or depression over the course of treatment, although there was a mean group reduction in maladaptive coping.Conclusion: Although the trial was uncontrolled and the sample size small, which limits interpretation, the results are consistent with an ineffective intervention. Because a null result would be consistent with previously reported psychotherapeutic trials in cases of IBD, and because SE therapy has been effective in treating other medically ill populations, we discuss characteristics of IBD that may account for a relative resistance to psychotherapeutic support. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that there are significant psychological and behavioural sequelae associated with having a family history of breast cancer (BC) which can interfere with comprehension of risk estimates.Purpose: The purpose of this study was to develop, standardize and do preliminary testing of a group intervention designed to address the emotional impact of having a family history of BC.Methods: This study is a single-arm pilot design with pre- and post-measures of perceived risk, psychosocial distress, knowledge and screening practices.Results: The primary study outcome measure of risk comprehension was significantly improved by 70%, according to our predetermined criteria for success. In addition, the most important secondary measures of psychosocial functioning, such as cancer-related distress (p=0.025), depression (p=0.05), anxiety (p=0.005) and unresolved grief (p=0.034) were significantly improved.Conclusion: The results of this initial pilot study are encouraging; however, further research is required, using a randomized controlled study design to evaluate the relative contribution of this intervention to the successful modification of risk comprehension, enhanced psychological functioning, and to promote optimal screening adherence. [ABSTRACT FROM AUTHOR]

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Introduction: Hypertensive disorders of pregnancy are associated with maternal and perinatal health risk. Some studies have demonstrated blood pressure reduction from the use of relaxation therapies, although previous study in pregnancy was limited. We undertook a RCT to determine the effects of guided imagery relaxation on BP and anxiety in hypertensive women during pregnancy, to answer feasibility questions for a larger trial., Objectives: This presentation will describe experiences and satisfaction with study participation, as reported by women in our study., Methods: Pregnant women with hypertension (n=69) were randomized to two daily periods of guided imagery or quiet rest, for 4weeks or until delivery, whichever came first. Participants provided compliance data and evaluated guided imagery each week, and completed postpartum questionnaires about their satisfaction with study participation., Results: Sixty women completed at least one week in the study. Compliance with allocated group conditions was high. Most women were satisfied with their allocation; 83.3% would choose to be in the study again. A greater proportion (42.4%) indicated that the study reassured them, compared to 3.4% who felt it added to their worry. Of those in the Guided Imagery group providing ratings, more than 75% reported enjoyment and ease of use. Most indicated they would use it for future hypertension in pregnancy and for stress, and would recommend it to others., Conclusion: Our results suggest that Guided Imagery may moderate BP increases in pregnant women with hypertension. However, success of any clinical intervention requires a high degree of patient compliance and acceptability. Guided imagery was acceptable, based on reported use and intent to use it for future stress and hypertension. Guided imagery can be used by hypertensive pregnant women to promote relaxation. Further research is required to determine whether it can improve physical and psychological health outcomes during pregnancy, birthing and postpartum., (Copyright © 2012. Published by Elsevier B.V.)

A positive genetic test result may impact on a person's self-concept and affect quality of life. The purpose of the study was to develop a self-concept scale to measure such impact for individuals carrying mutations for a heritable colorectal cancer Lynch syndrome (LS). Two distinct phases were involved: Phase 1 generated specific colorectal self-concept candidate scale items from interviews with eight LS carriers and five genetic counselors, which were added to a previously developed self-concept scale for BRCA1/2 mutation carriers, Phase II had 115 LS carriers complete the candidate scale and a battery of validating measures. A 20-item scale was developed with two dimensions identified through factor analysis: stigma/vulnerability and bowel symptom-related anxiety. The scale showed excellent reliability (Cronbach's α = 0.93), good convergent validity by a high correlation with impact of event scale (r(102) = 0.55, p < 0.001) and Rosenberg self-esteem scale (r(108) = -0.59, p < 0.001), and a low correlation with the Fear questionnaire (r(108) = 0.37, p < 0.001). The scale's performance was stable across participant characteristics. This new scale for measuring self-concept has potential to be used as a clinical tool and as a measure for future studies., (© 2011 John Wiley & Sons A/S.)

A type of hereditary colorectal cancer (CRC) known as hereditary nonpolyposis colorectal cancer (HNPCC) is associated with MLHI and MSH2 gene mutations. This study consists of a pilot, cross-sectional study of 50 individuals who were engaged in the genetic testing process for HNPCC. The study investigated the motivations and attitudes around genetic testing and current psychosocial functioning through the use of standardized measures, as well as obtained information on disclosure patterns associated with test results. The mean age of the sample was 44.3 years. (SD = 15.0). Twenty-three individuals were identified as "carriers" (13 had a previous history of CRC), seven were "non-carriers" and 20 individuals were still awaiting test results. The primary motivations for participating in genetic testing were similar to previous reports and included: wanting to know if more screening tests were needed, obtaining information about the risk for offspring and increasing certainty around their own risk. The psychosocial scores demonstrated that a subgroup of individuals exhibited distress, with greater distress for those individuals awaiting results or testing positive. There was a high level of satisfaction associated with the experience of testing. Individuals in this study tended to disclose their test results to a variety of family and non-family members. Disclosure was primarily associated with positive experiences however, some individuals reported regret around disclosure of their results. These preliminary findings should be further explored in a larger prospective study design over multiple time points.

Objective: The relationship between characteristics of self-soothing ability, the capacity for evocative memory, and aloneness was investigated in a clinical sample of 50 bulimia nervosa (BN) patients., Method: Individuals meeting DSM-III-R criteria for BN who participated in a randomized trial of guided imagery completed measures of Soothing Receptivity and a modified version of the UCLA-Loneliness scale, resulting in the Aloneness/Evocative Memory Scale., Results: A lower level of soothing receptivity (indicating a decreased capacity for self-soothing) was correlated with a decreased capacity for evocative memory. A lower level of soothing receptivity and decreased capacity for evocative memory were associated with a greater experience of aloneness., Discussion: Results suggest the need for a more comprehensive understanding of the role of affect regulation and the experience of aloneness in BN and the need to develop treatments to specifically address these features of the illness., (Copyright 2000 by John Wiley & Sons, Inc.)

Bulimia nervosa (BN) has been described as involving impairment in affect regulation and in self-soothing. Such a conceptualization suggests the need to design treatments that specifically target these problems in order to assist individuals with BN in comforting themselves. A model of guided imagery therapy suggests that imagery therapy has multiple levels of action and can assist these individuals in the regulation of affect by providing an external source of soothing and also by enhancing self-soothing. The authors illustrate the model with a case example and report the results of a study in a clinical sample of BN.

Sixty-one women with newly diagnosed locoregional breast cancer (T1-3, N0-1, M0) having an initial Body Mass Index (BMI) between 20 and 35 kg/m2 who were receiving standard adjuvant treatment (chemotherapy, tamoxifen, and/or radiation) were asked to avoid weight gain (if initial BMI < or = 25 kg/m2) or to lose up to 10 kg (if initial BMI 25-35 kg/m2) over one year. Women participated in twenty group sessions (10 weekly, 10 monthly) which involved a psychological supportive-expressive group intervention supplemented by individual weight goals, and nutrition and exercise programs. Fifty-five non-censored women (5 developed recurrence, 1 died of a subarachnoid hemorrhage) lost a mean of 0.53 +/- 3.72 kg. Weight loss was greatest in initially overweight women (BMI > or = 25 kg/m2) who lost 1.63 +/- 4.11 kg (p = 0.01 compared to normal weight women) and in those not receiving chemotherapy who lost 2.15 +/- 2.83 kg (p = 0.0004 compared to those receiving chemotherapy). 70.9% met predefined criteria for success. Aerobic exercise increased significantly during the intervention (p = 0.00005) and was the strongest predictor of success (OR 1.73 for each additional 30 minutes of exercise weekly, p = 0.003). Changes in caloric intake were not significant, but fat intake decreased and carbohydrate and fibre intake increased significantly during the intervention. Eating behavior and psychological status improved significantly. Thus, this multidisciplinary weight management intervention successfully prevented weight gain in women with newly diagnosed locoregional breast cancer, and helped overweight women lose weight.

This article conceptualizes impulsivity from the perspective of psychiatric nurses in the inpatient setting. A theoretical model of the nature and the process of impulsivity is developed phenomenologically from information obtained from psychiatric nurses and patient chart reviews. The impulsive event is characterized by three elements: (1) precipitants of the behavior, (2) characteristics of the impulsive event, and (3) staff response. The expression of these elements differentiates impulsivity according to patient domains of psychotic and nonpsychotic illnesses. The emerging differentiation provides the opportunity to develop distinct nursing interventions that target the impulsivity within each of these domains.