What to listen for in the consultation. Breast cancer patients’ own focus on talking about acceptance-based psychological coping predicts decreased psychological distress and depression

Objective

To analyze whether qualitative themes in breast cancer patients’ self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process.

Methods

Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression scale (CES-D).

Results

Among the qualitative themes, only the percentage of words spent on talking about ‘Acceptance-based psychological coping’ was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted less psychological distress and depression, respectively. A cross-validation including only the first few minutes of speech per patient confirmed these results and supported their practical utility in health consultations.

Conclusion

Patients’ focus on acceptance-based coping significantly predicted decreased psychological distress and depression, respectively. No other qualitative themes predicted symptoms. Doctor–patient studies may benefit from combined qualitative–quantitative methods.

Practice implications

While quantitative symptom assessment is important for a consultation, health care providers may improve their understanding of patients by attending to patients’ presentations of acceptance-based psychological coping.     

Sexy online self-presentation on social network sites and the willingness to engage in sexting: A comparison of gender and age

The present study investigated whether engaging in sexy self-presentations on social network sites (SNSs) or exposure to sexy self-presentations on SNSs predicts the willingness to engage in sexting. A second aim of the present study was to investigate whether adolescent girls demonstrate stronger relationships between (exposure to) sexy online self-presentations on SNSs and willingness to sext than adolescent boys and young adult men and women. A two-wave panel survey among 953 Dutch adolescents (13–17 years old, 50.7% male) and 899 Dutch young adults (18–25 years old, 43.9% male) showed that engaging in sexy self-presentations on SNSs increased the willingness to engage in sexting, but only among adolescent girls. Exposure to sexy self-presentations of others did not predict the willingness to engage in sexting. The findings call for more research on the role of gender and age in the link between sexy self-presentation and sexting.     

Small-cell lung cancer patients are just ‘a little bit’ tired: response shift and self-presentation in the measurement of fatigue

Background Response shift has gained increasing attention in the measurement of health-related quality of life (QoL) as it may explain counter-intuitive findings as a result of adaptation to deteriorating health. Objective To search for response shift type explanations to account for counter-intuitive findings in QoL measurement. Methods Qualitative investigation of the response behaviour of small-cell lung cancer (SCLC) patients (n = 23) in the measurement of fatigue with The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) question ‘were you tired’. Interviews were conducted at four points during 1st line chemotherapy: at the start of chemotherapy, 4 weeks later, at the end of chemotherapy, and 6 weeks later. Patients were asked to ‘think aloud’ when filling in the questionnaire. Results Fifteen patients showed discrepancies between their answer to the EORTC question ‘were you tired’ and their level of fatigue spontaneously reported during the interview. These patients chose the response options ‘not at all’ or ‘a little’ and explained their answers in various ways. In patients with and without discrepancies, we found indications of recalibration response shift (e.g. using a different comparison standard over time) and of change in perspective (e.g. change towards a more optimistic perspective). Patients in the discrepancy group reported spontaneously how they dealt with diagnosis and treatment, i.e. by adopting protective and assertive behaviour and by fighting the stigma. They distanced themselves from the image of the stereotypical cancer patient and presented themselves as not suffering and accepting fatigue as consequence of treatment. Conclusion In addition to response shift, this study suggests that ‘self-presentation’ might be an important mechanism affecting QoL measurement, particularly during phases when a new equilibrium needs to be found.     

The Medicines of Katherine,Duchess of Norfolk, 1463–71

This article discusses the medicinal remedies consumed at the court of the Yorkist kings of England in the light of a lawsuit in the court of common pleas (edited in an appendix) between John Clerk, king’s apothecary to Edward IV, and Katherine Neville, Duchess of Norfolk, over the partial non-payment of the apothecary’s bills. It argues that the consumption of apothecaries’ wares in large quantities was not merely a direct result of the excessive diet of the late medieval aristocracy, but in itself represented a facet of the conspicuous consumption inherent in the lifestyle of this particular social class. The remedies supplied by Clerk over a period of several years and listed in the legal record are set in the context of contemporary collections of medical recipes, particularly a ‘dispensary’ in the British Library’s Harleian collection generally attributed to the king’s apothecary.     

Perfectionism and undergoing cosmetic surgery

This study compared 16 women who had undergone cosmetic surgery (i.e., patients) to 16 women who had not (i.e., controls). Patients and controls were matched on relevant demographics (e.g., age). Socially prescribed perfectionism (i.e., perceiving that others demand perfection of oneself) and perfectionistic self-promotion (i.e., assertively promoting one’s supposed perfection to others) were significantly elevated in patients relative to controls. Extreme perfectionism was also shown to substantially increase the likelihood of undergoing cosmetic surgery. Results are discussed with respect to perfectionists’ cognitive style, interpersonal needs, chronic dissatisfaction, and hyper-competitive orientation. Perfectionism is considered as a possible contraindication for cosmetic surgery. An invited commentary on this paper is available at .     

Brief Report: Self-Presentation of Children with Autism Spectrum Disorders

The self-presentational behaviour of 43 6- to 12-year-old children with high functioning autism spectrum disorders (HFASD) and normal intelligence and 43 matched comparisons was investigated. Children were prompted to describe themselves twice, first in a baseline condition and then in a condition where they were asked to convince others to select them for a desirable activity (self-promotion). Even after controlling for theory of mind skills, children with HFASD used fewer positive self-statements at baseline, and were less goal-directed during self-promotion than comparison children. Children with HFASD alter their self-presentation when seeking personal gain, but do this less strategically and convincingly than typically-developing children.     

民族院校大学生炫耀性消费及其与幸福感水平的研究

目的了解大学生炫耀性消费状况及其与幸福感水平的关系。方法随机抽取中南民族大学在校大学生110名,发放自编调查问卷及总体幸福感量表进行调查。结果①与来自城市的同学相比,来自乡村和城镇的同学具有更大的经济压力;②消费状况调查中没有发现炫耀性倾向,但来自城市的大学生相对于来自乡村的大学生,消费态度和消费能力的限制都比较宽松;③每月生活消费水平较高的同学相对而言具有较高幸福感水平(F=3.582,P<0.05)。结论不同生活消费水平的大学生幸福感水平不同。     

自我呈现策略量表的中文版修订

目的对Suk-Jae编撰了64个项目的自我呈现策略量表进行中文版修订。方法通过中英文互译和课题组讨论翻译成64个项目中文版自我呈现策略初测问卷。研究阶段1在辽宁省某大学随机抽取300名大一学生进行问卷项目分析和验证性因素分析,确定53个项目,11个初级维度和2个次级维度;研究阶段2在该校再次随机抽取300名大学生使用阶段1修订的自我呈现策略问卷进行施测,并在两周后再次施测,确定问卷的信效度。结果修订后问卷保留53个项目,11个维度,积极自我呈现策略和消极自我呈现策略2个次级维度,各维度α系数在0.6~0.9之间,重测信度0.678~0.851之间,消极自我呈现策略、积极自我呈现策略和总量表的信度分别为0.927、0.784和0.907,结构效度初级模型与次级模型χ2/df分别为2.14和2.50。结论自我呈现策略量表具有较好的信效度,可作为中国人群自我呈现策略的评估工具。