Michael Hoerger

Michael Hoerger
Tulane University | TU · Tulane Cancer Center

About

110
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3,753
Citations
Citations since 2017
55 Research Items
1973 Citations
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Publications

Publications (110)
Preprint
Full-text available
Introduction Young children are susceptible to COVID-19 infection in high-risk settings because they cannot begin vaccination until at least 6 months old and cannot mask safely until at least 2 years old. During essential activities, parents have attempted to protect children in strollers using rain covers, but these provide limited protection agai...
Article
Prior interventions have repeatedly failed to decrease the prescription and receipt of treatments and procedures that confer more harm than benefit at the End-of-Life (EoL); new approaches to intervention are needed. Ideally, future interventions would be informed by a social-ecological conceptual model that explains EoL healthcare utilization patt...
Article
Background: Although palliative care programs are beneficial to patients and families, most of the public is unfamiliar with and underutilizes palliative services. TikTok, a fast-growing social media platform worldwide, allows users to share short live-recorded videos and could be used to educate the public about palliative care. Objective: This st...
Article
Patients with serious illnesses often do not engage in discussions about end-of-life care decision-making, or do so reluctantly. These discussions can be useful in facilitating advance care planning and connecting patients to services such as palliative care that improve quality of life. Terror Management Theory, a social psychology theory stating...
Article
Objective: Informed treatment decision-making necessitates accurate prognostication,including predictions about quality of life. We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients' future quality of life and whether these predictions are prospectively associated with end-of-life care and bere...
Article
This study assessed pediatric oncology professionals’ attitudes and attendance at patient funerals. Many professionals endorsed some level of agreement that funeral attendance respects professional boundaries. Nearly all pediatric oncology professionals (89.2%) reported attending a patient funeral at least once, a rate significantly higher than est...
Article
“Scenario planned provides a useful framework for scientists proposing and implementing new projects during the COVID-19 pandemic and other uncertain events.”
Article
Background: Palliative care is underutilized due in part to fear and misunderstanding, and depression might explain variation in fear of palliative care. Objective: Informed by the socioemotional selectivity theory, we hypothesized that older adults with cancer would be less depressed than younger adults, and subsequently less fearful of utilizing...
Article
Schizotypy is marked by negative symptoms including blunted affect, social isolation, and social anhedonia. Contemporary personality theory suggests that maladaptive shame regulation may disrupt interpersonal function across personality disorders. We hypothesized that "affect shame"-a conditioned response of shame evoked by openly expressing emotio...
Article
Psychology adds value to palliative care research and practice, but palliative psychology training programs are underdeveloped, particularly prior to advanced graduate and post-doctoral training. The investigation aimed to examine the feasibility of developing an undergraduate clinical research training program focused on the application of palliat...
Article
Objective End-of-life care for patients with cancer is often overly burdensome, and palliative and hospice care are underutilized. The objective of this study was to evaluate whether the mental health diagnoses of anxiety and depression were associated with variation in end-of-life care in metastatic cancer. Methods This study used electronic heal...
Article
Context: Early integrated palliative care improves quality of life, but palliative care programs are underutilized. Psychoeducational interventions explaining palliative care may increase patients' readiness for palliative care. Objectives: To (1) collaborate with stakeholders to develop the EMPOWER 2 intervention explaining palliative care, (2)...
Article
Finding meaning in life is important for maintaining physical and mental well-being. Obtaining a deeper understanding of activities that patients with cancer find meaningful is essential in improving cancer care and increasing meaning in life in these individuals. The sample of the present study consisted of patients with cancer ( N = 61) who repor...
Article
Tobacco use is a leading preventable cause of early mortality and is prevalent among adults with mental health diagnoses, especially in the southern USA. Increasing cessation resources in outpatient mental health care and targeting individuals most receptive to changing their behavior may improve cessation. Drawing on the transtheoretical model, ou...
Article
PurposeThe present study examined the prevalence of changes in the taste and smell of food among men with advanced prostate cancer who were receiving hormone therapy and/or chemotherapy.Method Participants were 75 men with advanced prostate cancer treated at an academic medical center. They completed a prospective survey about nausea while eating,...
Article
This review examines the health implications of research on affective forecasting, the process of predicting future emotional states. Basic research in social and cognitive psychology has shown that people are biased in their perceptions of future emotional states. In nonclinical samples, these biases have been shown to foster choices that fail to...
Article
Context: Cancer patients' comfort near the end of life is often undermined by unnecessary and burdensome treatments. There is a need for more research examining racial disparities in end-of-life care, especially in regions with a history of racial discrimination. Objectives: To examine whether Black adults received more burdensome end-of-life ca...
Article
In the wake of COVID-19, the capacity to track emerging trends in mental health symptoms and needs will guide public health responses at multiple ecological levels. Using Google Trends to track population-level mental health-related Google searches in the United States, this investigation identified pandemic-associated spikes in searches related to...
Article
Purpose: To examine whether adults with cancer view affective forecasting as important for treatment decisions, and to examine these perceptions among key subgroups. Design: Adults with cancer (N = 376) completed a cross-sectional survey that included demographic and clinical characteristics, the IPIP five-factor personality measure, and a rating o...
Article
Full-text available
Background Palliative care is a specialized approach to symptom management that focuses on supporting patients’ physical and psychological quality of life throughout the disease course. In oncology, palliative care has been increasing in utilization. The evidence base for such care is also growing through the use of randomized controlled trials (RC...
Article
Background Opioid overdoses have reached epidemic levels in the United States and have clustered in Northeastern and “Rust Belt” states. Five Factor Model (FFM) personality traits also vary at the state level, with anger-prone traits clustered in the Northeast region. This study tested the hypothesis that state-level anger proneness would be associ...
Article
Self-complexity, the extent that people experience themselves as having a number of distinct and meaningful social roles, may have implications for young adults’ socio-emotional adjustment to romantic life events. Based on prior research, we hypothesized that participants who reported lower self-complexity would have worse adjustment to a negative...
Article
Objective: Social support is fundamentally important to the well-being of patients with cancer, and informal caregivers often wish they had better insight into how to help. The aims of this study were to quantify the types of social support that patients qualitatively expressed as important, and examine whether demographics and mental health sympto...
Poster
46 Background: Cancer patients’ comfort near the end of life is often undermined by unnecessary aggressive treatments. Furthermore, Black adults receive more aggressive end of life care compared to White adults. We hypothesized that these inequalities would be especially pronounced in Louisiana given regional trends of high cancer mortality coupled...
Article
Full-text available
Context: There has been surprisingly little attention to conceptual and methodological issues that influence the measurement of discretionary utilization at the end-of-life (DIALs), an indicator of quality care. Objective: To examine how DIALs have been operationally defined, and identify areas where evidence is biased or inadequate to inform pr...
Article
Context: Palliative care is underutilized, and research has neglected patient-level factors including attitudes that could contribute to avoidance or acceptance of palliative care referrals. This may be due in part to a lack of existing measures for this purpose. Objectives: To develop and validate a 9-item scale measuring patient attitudes towa...
Article
The Mini International Personality Item Pool (Mini-IPIP) is a brief measure of the Five-Factor Model of personality with documented validity in healthy samples of adults and could be useful for assessing personality in patient populations such as individuals with cancer. The purpose of this study was to examine the psychometric properties of the Mi...
Article
Purpose/Objectives: Screening for distress is a key priority in cancer care, and African American patients may experience increased distress compared to White patients. However, this question has not yet been addressed in Louisiana. The purpose of the present study was to examine the relationship between African American race and distress at a canc...
Article
Background: Care teams are increasingly expected to attend to the needs of patient's personal caregivers (e.g., family members). Improving communication among oncologists, patients with advanced cancer, and their personal caregivers might enhance caregivers' experiences of end-of-life (EoL) cancer care and bereavement outcomes. Objective: To explo...
Article
Context: Few studies have examined the association between financial strain and quality of life outcomes in breast cancer. Objectives: To examine the association between financial strain and key elements of physical and emotional quality of life among women with breast cancer. Methods: Across three geographically diverse samples (census region...
Poster
Delay of gratification depends on cognitive control, or the ability to suppress competing inappropriate thoughts or actions in favor of appropriate ones (Casey et al., 2011). Deficits in gratification delay are associated with a broad range of public health problems, such as obesity and substance abuse (Hoerger et al., 2011).
Article
Full-text available
Context: Although patient and physician characteristics are thought to be predictive of discretionary interventions at the end of life (EoL), few studies have data on both parties. Objective: To test the hypothesis that patient preferences and physician attitudes are both independently associated with discretionary interventions at the EoL. Met...
Poster
151 Background: Research has not thoroughly examined patient-level factors such as perceptions that could contribute to underutilization of palliative care, which may be due in part to a lack of existing measures for this purpose. Therefore, this investigation aimed to develop and validate a 9-item measure called the Palliative Care Preferences Sca...
Poster
34 Background: Palliative care is underutilized by patients with cancer. Understanding differences in preferences is critical for promoting access. This study tested the hypothesis that women would be more favorably disposed toward palliative care than men. Methods: Two samples of individuals with cancer ( N = 633 and N = 413) provided data on demo...
Article
Background: Geographic disparities in access to palliative care cause unnecessary suffering near the end-of-life in low-access U.S. states. The psychological mechanisms accounting for state-level variation are poorly understood. Objective: To examine whether statewide differences in personality account for variation in palliative care access. Des...
Poster
57 Background: There are geographic disparities in access to palliative care that cause unnecessary suffering near the end of life in low-access U.S. states. The psychological mechanisms explaining state-by-state variation in access to palliative care are poorly understood. Our objective was to examine whether state-level differences in personality...
Article
Background In advanced cancer, patients want to know how their care options may affect survival and quality of life, but the impact of outpatient specialty palliative care on these outcomes in cancer is uncertain. Purpose To estimate the impact of outpatient specialty palliative care programs on survival and quality of life in adults with advanced...
Article
Full-text available
Context: Physician aid in dying is a controversial topic in the United States, and legislation exists in some states. Personality traits are associated with preferences for end of life care, and also tend to cluster systematically across states and other geographic regions. Such clustering of personality traits could relate to legislation includin...
Article
Context: Men and those with low educational attainment are less likely to receive palliative care. Understanding these disparities is a high priority issue. Objective: In this study of advanced cancer patients, we hypothesized that men and those with lower levels of educational attainment would have less favorable attitudes towards palliative ca...
Article
Personality is associated with health, but studies examining this association in patients with serious illnesses are lacking. This cross-sectional study involved 168 participants without cancer, 212 men with prostate cancer, and 55 women with breast cancer. We examined whether the Big Five personality dimensions were associated with health behavior...
Article
Objective: To evaluate the relationship between personality and emotional distress in prostate cancer. Neuroticism and introversion were hypothesized to be associated with clinically significant symptoms of emotional distress, including depression, anxiety, and suicidal ideation. Methods: Men with a history of prostate cancer (n=212) completed a...
Conference Paper
154 Background: Early PC integrated with oncology care improves quality of life, mood and the delivery of EOL care among patients with advanced cancer, but little is known about which elements of PC practice are associated with such outcomes. The goals of this study were to describe the key elements of early PC across the illness trajectory and exa...
Article
Caregivers of patients with advanced cancer are affected physically and emotionally by the patient's illness and are too often overlooked by health care systems. This commentary considers recent findings that early integrated palliative care is beneficial for reducing emotional distress in both patients and caregivers.
Article
The DASS-21 is a public domain instrument that is commonly used to evaluate depression and anxiety in psychiatric and community populations; however, the factor structure of the measure has not previously been examined in oncologic settings. Given that the psychometric properties of measures of distress may be compromised in the context of symptoms...
Article
Objective Understanding socioeconomic disparities in the care of patients with incurable cancer is a high priority. We hypothesized that patients without a high school education are more likely to believe that they could be cured and we explored the role of fatalism. Methods We studied 977 patients with advanced, incurable cancer. Two logistic reg...
Article
10042 Background: Depression is common in caregivers (cgs) of patients (pts) with cancer. However, little is known about the association of health status of older pts with cancer with cg emotional health. Methods: Baseline data from a GA intervention study conducted at 68 oncology practices in the UR NCORP were analyzed. Pts aged ≥ 70 with an advan...
Article
Objectives: Randomized controlled trials, especially the Early Palliative Care Study (Temel et al., 2010), have shown that early outpatient palliative cancer care can improve quality of life for patients with advanced cancer or serious symptoms. However, fear and misconceptions drive avoidance of palliative care. Drawing from an empowerment perspe...
Article
Full-text available
Importance: Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. Objective: To determine whether a combined intervention involving oncologists, patients with...
Article
In light of recent health care reforms, we have provided an illustrative example of new opportunities available for psychologists to develop patient-reported measures related to health care quality. Patient engagement in health care decision making has been increasingly acknowledged as a vital component of quality cancer care. We developed the 10-i...
Article
Importance Patients with advanced cancer often report expectations for survival that differ from their oncologists’ expectations. Whether patients know that their survival expectations differ from those of their oncologists remains unknown. This distinction is important because knowingly expressing differences of opinion is important for shared dec...
Article
Full-text available
Purpose. Family members’ responsibilities for patients with cancer have increased dramatically over the past decade and will likely continue to rise. Given that caregiving is associated with declines in self-care, there is a need for research on caregivers’ perceptions of their own health. The purpose of this study was to examine whether personalit...
Article
Objectives: Mindfulness-based stress reduction (MBSR) is a promising intervention for older adults seeking to improve quality of life. More research is needed, however, to determine who is most willing to use the four techniques taught in the program (yoga, sitting meditation, informal meditation, and body scanning). This study evaluated the relat...
Article
Aim: Anger is a common reaction to cancer diagnosis which may impact patients' perceptions of their prognosis and goals of care. This study tested the hypothesis that men with prostate cancer who are anger prone are pessimistic regarding their cancer prognosis. Methods: Two hundred and twelve men with a history of prostate cancer completed measu...
Article
Objective: Over 2 million American women at elevated risk for breast cancer are eligible to take chemoprevention medications such as tamoxifen and raloxifene, which can cut in half the risk of developing breast cancer, but which also have a number of side effects. Historically, very few at-risk women have opted to use chemoprevention medications....
Article
The Affordable Care Act (ACA) represents a paradigm shift in the U.S. health care system, which has implications for psychology programs producing the next generation of trainees. In particular, the ACA has established the Patient-Centered Outcomes Research Institute (PCORI), which has been tasked with developing national priorities and funding res...
Article
Context: Increased focus on patient-centered care models has contributed to greater emphasis on improving quality of life at the end of life through personalized medicine. However, little is known about individual-level factors impacting end-of-life care preferences. Objectives: To examine whether the five-factor model of personality explains va...
Article
The U.S. Food and Drug Administration's Expanded Access program allows patients with life-threatening diagnoses, such as advanced cancer, to use experimental medications without participating in clinical research (colloquially, "Compassionate Use"). Sixteen U.S. states recently passed "right-to-try" legislation aimed at promoting Expanded Access. A...
Article
Full-text available
Affective forecasting often drives decision-making. Although affective forecasting research has often focused on identifying sources of error at the event level, the present investigation draws upon the "realistic paradigm" in seeking to identify factors that similarly influence predicted and actual emotions, explaining their concordance across ind...
Article
Patient-centered cancer care standards include routine psychosocial distress screening and referral for supportive care services. Although many cancer patients report psychosocial distress that could be alleviated by supportive services including palliative care, patients often decline such services for reasons that are poorly understood. Research...
Article
This pilot study employed a moderated mediation framework to examine whether negative expectations of interpersonal relationships explained the relationship between experiential avoidance and interpersonal problems. University students (N=159) completed measures of experiential avoidance, negative perceptions and expectations of interpersonal relat...
Article
Full-text available
Personality is relatively stable in adulthood but could change in response to life transitions, such as caring for a spouse with a terminal illness. Using a case-control design, spousal caregivers (n=31) of patients with terminal lung cancer completed the NEO-FFI twice, 1.5 years apart, before and after the patient's death. A demographically-matche...
Article
Full-text available
The Affordable Care Act has established a new fund-ing institute, called the Patient-Centered Outcomes Research Institute (PCORI), which has widespread implications for psy-chology research in the medical setting. PCORI aims to improve healthcare quality and reduce costs by funding research that will help patients to make more informed healthcare d...
Conference Paper
INTRODUCTION: Although the majority of research on process indicators of implementation quality (IQ) focuses on individual psychotherapy (Norcross, 2002), these factors may be equally relevant for community-based programs aimed at preventing socioemotional problems. In prior work, we advanced the conceptualization of five aspects of IQ (therapeutic...
Article
Objectives: To examine the effects of age and depressive symptom severity on changes in positive affect among older adults randomly assigned to a Mindfulness-Based Stress Reduction (MBSR) program or a Waitlist Control group. Drawing from the Motivational Theory of Life-Span Development, we hypothesized that lower levels of depressive symptom sever...
Article
Full-text available
Background Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers. Methods/design The Values and Options in Cancer Care (V...
Article
The ability to delay gratification and wait for larger long-term rewards is crucial for maximizing outcomes in commonly valued areas of living such as career, health, and relationships. Past research suggests that emotional distress impairs this ability to delay gratification. Research also indicates that persons who exhibit higher levels of experi...
Article
Full-text available
Bipolar disorder is characterised by impulsivity, and recent research suggests it is important to consider more specific forms of impulsivity. In two student samples, we examined associations of self-reported impulsivity with mania risk (Hypomanic Personality Scale, HPS). We hypothesised that mania risk would relate to impulsivity in the context of...
Article
Full-text available
Objectives: The objectives of this study were to examine the effects of specific Mindfulness-Based Stress Reduction (MBSR) activities (yoga, sitting and informal meditation, body scan) on immune function, circulating insulin-like growth factor (IGF)-1 concentrations, and positive affect among older adults. Design: The study design comprised long...
Article
This study examined the association between recollected parental child-rearing strategies and individual differences in self-regulation, socio-emotional adjustment, and psychopathology in early adulthood. Undergraduate participants (N = 286) completed the EMBU - a measure of retrospective accounts of their parents' child-rearing behaviors - as well...
Article
Full-text available
Emerging research has examined individual differences in affective forecasting; however, we are aware of no published study to date linking psychopathology symptoms to affective forecasting problems. Pitting cognitive theory against depressive realism theory, we examined whether dysphoria was associated with negatively biased affective forecasts or...
Chapter
Full-text available
This chapter narrows the gap between Internet technology and research ethics so that psychologists can strive to meet exemplary ethical standards and, at the very least, avoid many of the common ethical pitfalls of Internet-mediated research. Although advanced methodological issues are beyond the scope of this chapter, basic design considerations a...
Article
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Only recently have researchers begun to examine individual differences in affective forecasting. The present investigation was designed to make a theoretical contribution to this emerging literature by examining the role of emotional intelligence in affective forecasting. Emotional intelligence was hypothesized to be associated with affective forec...
Article
Full-text available
Affective forecasting skills have important implications for decision making. However, recent research suggests that immune neglect - the tendency to overlook coping strategies that reduce future distress - may lead to affective forecasting problems. Prior evidence for immune neglect has been indirect. More direct evidence and a deeper understandin...
Article
Full-text available
Deficits in gratification delay are associated with a broad range of public health problems, such as obesity, risky sexual behavior, and substance abuse. However, 6 decades of research on the construct has progressed less quickly than might be hoped, largely because of measurement issues. Although past research has implicated 5 domains of delay beh...
Article
Full-text available
In a sample of 77 dyads, involving depressed patients at least 50 years of age and their family or friends (informants), patient illness burden and cognitive decline were associated with self-informant rating discrepancies for facets of Revised NEO Personality Inventory (NEO-PI-R) Openness and Extraversion. Informant judgments about Neuroticism and...
Article
Full-text available
Internet-mediated research has offered substantial advantages over traditional laboratory-based research in terms of efficiently and affordably allowing for the recruitment of large samples of participants for psychology studies. Core technical, ethical, and methodological issues have been addressed in recent years, but the important issue of parti...
Article
Recent studies on affective forecasting clarify that the emotional reactions people anticipate often differ markedly from those they actually experience in response to affective stimuli and events. However, core personality differences in affective forecasting have received limited attention, despite their potential relevance to choice behavior. In...
Article
Full-text available
Often to the detriment of human decision making, people are prone to an impact bias when making affective forecasts, overestimating the emotional consequences of future events. The cognitive processes underlying the impact bias, and methods for correcting it, have been debated and warrant further exploration. In the present investigation, we examin...
Chapter
R.A. Fisher, though most often associated with multiple-subject designs, first introduced a single-subject (clinical trial of N-of-1) experimental paradigm in 1945 [1]. Since this introduction, the single subject design has been used most frequently within the social and educational sciences [2]. This design, however, has recently been applied for...
Chapter
Although there is a long tradition of employing single subject designs in social science research, these designs have only recently been utilized in biomedicine. The single subject design methodology has been overlooked in biomedicine, even though physicians are essentially conducting single subject (N-of-1) trials when conducting patient care (i.e...