[Show abstract][Hide abstract] ABSTRACT: According to the social-cognitive processing model (Lepore, 2001), social constraints on disclosure can limit an individual's ability to communicate openly with others and consequently have negative effects on psychological adjustment, especially in the context of stressful experiences such as the diagnosis and treatment of cancer. The goal of the present study was to examine the influence of social constraints on daily event sharing, individual well-being, and relationship well-being in couples coping with breast cancer. Forty-five patients recently diagnosed and treated for early stage breast cancer and their spouses reported perceptions of spousal constraints on patient disclosure and completed a 7-day electronic diary. Analyses revealed that patient-reported social constraints, independent of the spouse's report, were linked to reduced patient sharing of both cancer-related and other important daily events. Patient and spouse perceptions of social constraints, independent of their shared consensus, predicted reduced daily individual well-being indexed by self-esteem and negative affect, as well as reduced daily relationship well-being indexed by relationship happiness and intimacy. Moreover, many of the aforementioned effects on daily well-being remained after controlling for global marital quality. Overall, these findings reveal that individual perceptions of social constraints have a negative influence on both patient and spouse daily well-being outcomes.
Journal of Family Psychology 06/2012; 26(4):661-7. DOI:10.1037/a0028655 · 1.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Fifty-three breast cancer patients completed an Internet-based diary measuring daily negative affect and positive affect and daily negative and positive events for seven consecutive evenings shortly after surgery. The authors used Hierarchical Linear Modeling (Raudenbush and Bryk in Hierarchical linear models: applications and data analysis methods. Sage, Thousand Oaks, CA, 2002) to examine moderators of affective differentiation, or the daily relationship between the patients' negative affect and positive affect. Strong affective differentiation is characterized by the relative independence of negative and positive affect. There were no significant Level 1 (within-subject) moderators of affective differentiation. However, at Level 2 (between-subject), as predicted, increased age was associated with stronger affective differentiation, as was greater use of planning to cope with breast cancer. Also as predicted, increased anxiety and greater use of behavioral disengagement and denial coping were associated with weaker affective differentiation. The results suggest the value of the affective differentiation construct, and a daily diary methodology, for research on the daily lives of breast cancer patients.
Journal of Behavioral Medicine 12/2010; 33(6):441-53. DOI:10.1007/s10865-010-9274-8 · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study used a daily diary design to evaluate depressed patients' changes on daily stress-related variables during cognitive therapy (CT). Patients completed daily diaries on two week-long occasions: after the intake interview and again after the sixth session of CT. Patients also completed a measure of depressive symptoms before every treatment session. After six sessions of CT, patients reported a significant reduction in: (a) depressive symptoms; (b) daily sad affect (SA); (c) daily negative thoughts associated with the day's most stressful event; and (d) SA reactivity to daily stressors. In addition, patients reported a significant increase in: (e) daily positive affect (PA); and (f) SA reactivity to daily negative thoughts. The results suggest that CT has its intended effects on the daily lives of depressed adults, and highlight the value of a daily diary methodology for research on CT.
Behaviour Research and Therapy 03/2009; 47(5):444-8. DOI:10.1016/j.brat.2009.02.005 · 3.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study evaluated the predictive role of depressed outpatients' (N = 62) affective reactivity to daily stressors in their rates of improvement in cognitive therapy (CT). For 1 week before treatment, patients completed nightly electronic diaries that assessed daily stressors and negative affect (NA). The authors used multilevel modeling to compute each patient's within-day relationship between daily stressors and daily NA (within-day reactivity), as well as the relationship between daily stressors and next-day NA (next-day reactivity; affective spillover). In growth model analyses, the authors evaluated the predictive role of patients' NA reactivity in their early (Sessions 1-4) and late (Sessions 5-12) response to CT. Within-day NA reactivity did not predict early or late response to CT. However, next-day reactivity predicted early response to CT, such that patients who had greater NA spillover in response to negative events had a slower rate of symptom change during the first 4 sessions. Affective spillover did not influence later response to CT. The findings suggest that depressed patients who have difficulty bouncing back the next day from their NA reactions to a relative increase in daily negative events will respond less quickly to the early sessions of CT.
Journal of Consulting and Clinical Psychology 01/2009; 76(6):955-65. DOI:10.1037/a0014131 · 4.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The current study tested whether daily interpersonal events predicted fatigue from one day to the next among female chronic pain patients.
Self-reported fatigue, daily events, pain, sleep quality, depressive symptoms, and functional health across 30 days were assessed in women with rheumatoid arthritis (RA: n = 89), Osteoarthritis (OA: n = 76), and Fibromyalgia syndrome (FM: n = 90).
Self-report fatigue measured on a 0 to 100 scale and fatigue affect from PANAS-X (Watson & Clark, 1994).
Multilevel analyses showed that both higher average levels of and daily increases in negative events predicted more fatigue, whereas daily increases in positive events predicted less fatigue. Across all pain conditions, increases in negative events continued to predict higher fatigue on the following day. Moreover, for participants with FM or RA, increases in positive events also predicted increased fatigue the following day. Daily increases in fatigue, in turn, predicted poorer functional health on both the same day and the next day.
These results indicate that both on average and on a daily basis, interpersonal events influence levels of fatigue beyond common physical and psychological correlates of chronic pain and highlight differences between chronic pain groups.
Health Psychology 12/2008; 27(6):694-702. DOI:10.1037/0278-6184.108.40.2064 · 3.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This research examined whether cognitive behavioral therapy and mindfulness interventions that target responses to chronic stress, pain, and depression reduce pain and improve the quality of everyday life for adults with rheumatoid arthritis (RA). The 144 RA participants were clustered into groups of 6-10 participants and randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P); mindfulness meditation and emotion regulation therapy (M); or education-only group (E), which served as an attention placebo control. The authors took a multimethod approach, employing daily diaries and laboratory assessment of pain and mitogen-stimulated levels of interleukin-6 (IL-6), a proinflammatory cytokine. Participants receiving P showed the greatest Pre to Post improvement in self-reported pain control and reductions in the IL-6; both P and M groups showed more improvement in coping efficacy than did the E group. The relative value of the treatments varied as a function of depression history. RA patients with recurrent depression benefited most from M across several measures, including negative and positive affect and physicians' ratings of joint tenderness, indicating that the emotion regulation aspects of that treatment were most beneficial to those with chronic depressive features.
Journal of Consulting and Clinical Psychology 07/2008; 76(3):408-21. DOI:10.1037/0022-006X.76.3.408 · 4.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study examined the role of past episodes of depression on pain reports for patients with rheumatoid arthritis (RA) before and during stress induction. A history of major depressive episodes was assessed by diagnostic interviews for 138 RA patients, 74 who later participated in a set of laboratory procedures designed to induce interpersonal stress. Patients were evaluated by a rheumatologist and then asked to report joint and bodily pain throughout the laboratory study. We found that RA patients with a history of two or more episodes of major depression had more pain at baseline, and exhibited higher pain in response to the stress induction than did RA patients with either only one episode or no history of depression. Such findings provide new insight in the dynamic relationships between depression, stress, and pain.
Journal of Behavioral Medicine 07/2007; 30(3):187-97. DOI:10.1007/s10865-007-9097-4 · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Lawrence Cohen The current study was based on O’Neill, Cohen, Tolpin, and Gunthert (2004) and was designed to evaluate the direction of the relationship between affective reactivity to daily stress and depressive symptoms. College students were assessed at two time periods (time 1 and time 2) with questionnaires measuring their current depressive symptoms and with daily diaries measuring their interpersonal and non-interpersonal stressors and their negative affect (NA) and positive affect (PA). We calculated indices of daily affective reactivity based on the respective within-person relationships between daily affect (NA and PA) and number of daily interpersonal and non-interpersonal stressors. Consistent with O’Neill et al., the results demonstrated that time 1 NA reactivity to daily interpersonal stressors predicted time 2 depressive symptoms. Unlike O’Neill et al., the results also demonstrated the predictive role of time 1 NA reactivity to daily non-interpersonal stressors. The results also suggested that these NA reactivity-depressive symptom relationships are unidirectional. Overall, the findings suggest that NA reactivity to daily stressors is a vulnerability factor for depression, and they highlight the value of a daily diary design in evaluating the antecedents and outcomes of psychopathology. University of Delaware, Department of Psychology M.A.