This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright a b s t r a c t The immune system's efficacy in detecting and destroying cancer cells varies considerably throughout the stages of cancer development and its role may be critical particularly during the surgical period. Although surgery causes tumor cells to shed into the blood, immune cells have the capacity to destroy these tumor cells. However, surgery also suppresses cytotoxic capacity. It is particularly during this surgical period that psychological factors can have a significant dampening or strengthening impact on surgery-related immunomodulation response, thus exerting an effect on survival. This review describes the immune changes during the peri-surgical period and the influences psychological factors have on immune function, including the immune effects caused by psychological interventions in cancer patients. We recommend that future studies exploring the role of psychological factors on immune function and survival focus more on their influence during the peri-surgical period.
Repression is typically associated in literature with terms such as non-expression, emotional con... more Repression is typically associated in literature with terms such as non-expression, emotional control, rationality, anti-emotionality, defensiveness and restraint. Whether these terms are synonymous with repression, indicate a variation, or are essentially different from repression is uncertain. We have discussed the similarities and differences between these concepts elsewhere (Garssen, 2007). In addition, a multitude of questionnaires has been developed in this field, which presents yet another problem for evaluating studies. In the present review, we critically discuss the various questionnaires used for measuring repression and related constructs, and then present our assessment on which scales are reliable and valid and which are not. The most appropriate repression measure is the Marlow Social Desirability (MC SD) scale, or the combination of the MC SD and an anxiety/distress scale. The question whether the MC SD scale alone, or the combination measure is
Literature on repression is abundant with terms such as repression, non-expression of negative em... more Literature on repression is abundant with terms such as repression, non-expression of negative emotions, emotional control, rationality, type C response style and defensiveness. However, it is uncertain whether these terms are synonymous with repression, denote a variation, or are essentially different from repression. In addition, a multitude of questionnaires has been developed in this field, which presents yet another problem for evaluating studies. Elsewhere we have discussed overlap of and differences between the various repression-related concepts (Garssen, 2007a) and critically reviewed eleven repression-related questionnaires (Garssen, 2009). The present study compares various repression questionnaires in two groups of women with breast cancer (N = 102 and 145). A secondary factor analysis yielded two factors, which were labelled: repression and anxious defensiveness. The relevance of this finding for future studies is that only scales belonging to the repression cluster are valid measures for measuring repression. The Marlowe Crowne Social Desirability scale is recommended as the most adequate repression measure.
In order to study synchronization of respiration, three different videofragments were presented t... more In order to study synchronization of respiration, three different videofragments were presented to 21 normal subjects. Each fragment showed a 'therapeutic interview' specially performed for this purpose, with a 'patient' breathing in a particular way. The respiration of model 1 was deep, slow and clearly audible, the pattern of model 2 was rapid, superficial and slightly audible and that of model 3 was normal, and hardly perceptible. The fragments were presented in three different sequences and each sequence was followed by seven subjects. Respiration amplitude (Vt), respiration irregularity (SD of Vt), respiration frequency (RF) and frequency of skin conductance responses (SCRF) were measured. Changes in mean values of these variables were demonstrated during the fragments; an increase in RF was the most pronounced and reliable change. These 'overall' physiological changes did not support the synchronization hypothesis, nor were they at variance with it: they seemed to be effects of attention. A detailed (cycle by cycle) analysis did reveal a synchronization effect in fragment 1. The number of cycles in the subject which were in rhythm with the model's respiration was significantly larger than could have been expected by chance. The effect of synchronization, however, was small and transient as it did not affect the mean RF and V t of fragment 1.
This study tests the hypothesis that social anxiety and fear of bodily sensations are associated ... more This study tests the hypothesis that social anxiety and fear of bodily sensations are associated with the development of agoraphobic avoidance behavior in panic disorder patients. Twenty patients with panic disorder were compared to 20patients with panic disorder with agoraphobia, matched by sex and duration of disorder. The two groups did not differ on measures of fear and frequency of assertive social responses. However, the agorapho-bics scored higher on measures of interpersonal sensitivity, depression, feelings of inadequacy, and hostility. They also reported higher fear of bodily sensations. Although definitive conclusions need to be postponed until prospective studies have been conducted, there is evidence suggesting that the development of agoraphobia in panic patients is associated with hypersensi-tivity to bodily sensations and interpersonal situations.
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright a b s t r a c t The immune system's efficacy in detecting and destroying cancer cells varies considerably throughout the stages of cancer development and its role may be critical particularly during the surgical period. Although surgery causes tumor cells to shed into the blood, immune cells have the capacity to destroy these tumor cells. However, surgery also suppresses cytotoxic capacity. It is particularly during this surgical period that psychological factors can have a significant dampening or strengthening impact on surgery-related immunomodulation response, thus exerting an effect on survival. This review describes the immune changes during the peri-surgical period and the influences psychological factors have on immune function, including the immune effects caused by psychological interventions in cancer patients. We recommend that future studies exploring the role of psychological factors on immune function and survival focus more on their influence during the peri-surgical period.
Objective: This study evaluated the psychological effects of a pre-surgical stress management tra... more Objective: This study evaluated the psychological effects of a pre-surgical stress management training (SMT) in cancer patients. Methods: Stress management training comprised four sessions in total: on 5 days and 1 day pre-surgery and on 2 days and 1 month post-surgery. Patients also received audio CDs with relaxation and coping skills exercises. Patients were randomly assigned to the SMT (N = 34) or a regular care condition (N = 36). Depression, anxiety, quality of life, perception of control, fatigue, pain, sleep problems, and surgery-related somatic symptoms were measured at Day 6 and Day 1 pre-surgery, and Day 2, 5, 30 and 90 post-surgery. Results: Depression and fatigue decreased in the intervention group and increased in the control group, leading to significant group differences at Day 2 (fatigue) and Day 5 post-surgery (fatigue and depression). It also appeared that surgery-related symptoms had increased more in the control group 3 months post-surgery than in the SMT group. No intervention effects were observed for anxiety, pain, and sleep problems. Conclusion: The use of a short psychological intervention is effective in reducing depression and fatigue in the post-surgical period, although the effects are of short duration.
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright a b s t r a c t The immune system's efficacy in detecting and destroying cancer cells varies considerably throughout the stages of cancer development and its role may be critical particularly during the surgical period. Although surgery causes tumor cells to shed into the blood, immune cells have the capacity to destroy these tumor cells. However, surgery also suppresses cytotoxic capacity. It is particularly during this surgical period that psychological factors can have a significant dampening or strengthening impact on surgery-related immunomodulation response, thus exerting an effect on survival. This review describes the immune changes during the peri-surgical period and the influences psychological factors have on immune function, including the immune effects caused by psychological interventions in cancer patients. We recommend that future studies exploring the role of psychological factors on immune function and survival focus more on their influence during the peri-surgical period.
Repression is typically associated in literature with terms such as non-expression, emotional con... more Repression is typically associated in literature with terms such as non-expression, emotional control, rationality, anti-emotionality, defensiveness and restraint. Whether these terms are synonymous with repression, indicate a variation, or are essentially different from repression is uncertain. We have discussed the similarities and differences between these concepts elsewhere (Garssen, 2007). In addition, a multitude of questionnaires has been developed in this field, which presents yet another problem for evaluating studies. In the present review, we critically discuss the various questionnaires used for measuring repression and related constructs, and then present our assessment on which scales are reliable and valid and which are not. The most appropriate repression measure is the Marlow Social Desirability (MC SD) scale, or the combination of the MC SD and an anxiety/distress scale. The question whether the MC SD scale alone, or the combination measure is
Literature on repression is abundant with terms such as repression, non-expression of negative em... more Literature on repression is abundant with terms such as repression, non-expression of negative emotions, emotional control, rationality, type C response style and defensiveness. However, it is uncertain whether these terms are synonymous with repression, denote a variation, or are essentially different from repression. In addition, a multitude of questionnaires has been developed in this field, which presents yet another problem for evaluating studies. Elsewhere we have discussed overlap of and differences between the various repression-related concepts (Garssen, 2007a) and critically reviewed eleven repression-related questionnaires (Garssen, 2009). The present study compares various repression questionnaires in two groups of women with breast cancer (N = 102 and 145). A secondary factor analysis yielded two factors, which were labelled: repression and anxious defensiveness. The relevance of this finding for future studies is that only scales belonging to the repression cluster are valid measures for measuring repression. The Marlowe Crowne Social Desirability scale is recommended as the most adequate repression measure.
In order to study synchronization of respiration, three different videofragments were presented t... more In order to study synchronization of respiration, three different videofragments were presented to 21 normal subjects. Each fragment showed a 'therapeutic interview' specially performed for this purpose, with a 'patient' breathing in a particular way. The respiration of model 1 was deep, slow and clearly audible, the pattern of model 2 was rapid, superficial and slightly audible and that of model 3 was normal, and hardly perceptible. The fragments were presented in three different sequences and each sequence was followed by seven subjects. Respiration amplitude (Vt), respiration irregularity (SD of Vt), respiration frequency (RF) and frequency of skin conductance responses (SCRF) were measured. Changes in mean values of these variables were demonstrated during the fragments; an increase in RF was the most pronounced and reliable change. These 'overall' physiological changes did not support the synchronization hypothesis, nor were they at variance with it: they seemed to be effects of attention. A detailed (cycle by cycle) analysis did reveal a synchronization effect in fragment 1. The number of cycles in the subject which were in rhythm with the model's respiration was significantly larger than could have been expected by chance. The effect of synchronization, however, was small and transient as it did not affect the mean RF and V t of fragment 1.
This study tests the hypothesis that social anxiety and fear of bodily sensations are associated ... more This study tests the hypothesis that social anxiety and fear of bodily sensations are associated with the development of agoraphobic avoidance behavior in panic disorder patients. Twenty patients with panic disorder were compared to 20patients with panic disorder with agoraphobia, matched by sex and duration of disorder. The two groups did not differ on measures of fear and frequency of assertive social responses. However, the agorapho-bics scored higher on measures of interpersonal sensitivity, depression, feelings of inadequacy, and hostility. They also reported higher fear of bodily sensations. Although definitive conclusions need to be postponed until prospective studies have been conducted, there is evidence suggesting that the development of agoraphobia in panic patients is associated with hypersensi-tivity to bodily sensations and interpersonal situations.
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright a b s t r a c t The immune system's efficacy in detecting and destroying cancer cells varies considerably throughout the stages of cancer development and its role may be critical particularly during the surgical period. Although surgery causes tumor cells to shed into the blood, immune cells have the capacity to destroy these tumor cells. However, surgery also suppresses cytotoxic capacity. It is particularly during this surgical period that psychological factors can have a significant dampening or strengthening impact on surgery-related immunomodulation response, thus exerting an effect on survival. This review describes the immune changes during the peri-surgical period and the influences psychological factors have on immune function, including the immune effects caused by psychological interventions in cancer patients. We recommend that future studies exploring the role of psychological factors on immune function and survival focus more on their influence during the peri-surgical period.
Objective: This study evaluated the psychological effects of a pre-surgical stress management tra... more Objective: This study evaluated the psychological effects of a pre-surgical stress management training (SMT) in cancer patients. Methods: Stress management training comprised four sessions in total: on 5 days and 1 day pre-surgery and on 2 days and 1 month post-surgery. Patients also received audio CDs with relaxation and coping skills exercises. Patients were randomly assigned to the SMT (N = 34) or a regular care condition (N = 36). Depression, anxiety, quality of life, perception of control, fatigue, pain, sleep problems, and surgery-related somatic symptoms were measured at Day 6 and Day 1 pre-surgery, and Day 2, 5, 30 and 90 post-surgery. Results: Depression and fatigue decreased in the intervention group and increased in the control group, leading to significant group differences at Day 2 (fatigue) and Day 5 post-surgery (fatigue and depression). It also appeared that surgery-related symptoms had increased more in the control group 3 months post-surgery than in the SMT group. No intervention effects were observed for anxiety, pain, and sleep problems. Conclusion: The use of a short psychological intervention is effective in reducing depression and fatigue in the post-surgical period, although the effects are of short duration.
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