Patients’ and partners’ expressed emotion in couples where the woman has breast cancer

TitlePatients’ and partners’ expressed emotion in couples where the woman has breast cancer
Publication TypeJournal Article
Year of Publication2013
AuthorsCharvoz, L, Favez, N, Cairo Notari, S, Panes-Ruedin, B, Antonini, T, Delaloye, J-F
JournalPsycho-Oncology
Volume22
NumberSuppl. 3
Pagination3-4
Abstract

BACKGROUND: Expressed Emotion (EE) is a construct assessing the emotional attitudes of relatives of individual with medical or psychiatric condition. Criticism, hostility, emotional overinvolvement are interpersonal aspects included in the EE-concept. The association between EE and the frequency and severity of symptoms, the patients’ management or adjustment to the illness were shown in medical diseases such as diabetes, rheumatoid arthritis or asthma. The purpose of this study is to examine associations between EE and breast cancer.

METHOD: Forty-two women diagnosed with a breast cancer were recruited in order to take part to a longitudinal study. Women and their partner completed a set of questionnaires evaluating their psychological distress (BSI-18, Zabora et al., 2001), their attitudes towards the partner (FAS, Kavanagh et al., 1997) and their relationship’s satisfaction (RAS, Hendrick, 1988). Moreover women filled in the QLQ-BR23 (EORTEC, 1996) assessing symptoms related to the treatment. Finally, each partner was filmed during 5 minutes talking about the other one and their relationship in order to assess EE (FMSS, Magana et al., 1986).

RESULTS: Preliminary results showed associations between partner’s negative attitudes towards the patient and the relationship (High Expressed Emotion HEE) and the level of somatisation, depression and anxiety of the patient. Women showing themselves toward their partners HEE reported higher scores in the scale assessing physical problems related to the operation and in the subscales evaluating their level of depression, anxiety and somatisation than women with a positive attitude (Low Expressed Emotion). Moreover, partner’s level of depression, anxiety and somatisation was higher in couples with a HEE woman. CONCLUSIONS: The preliminary results of this research suggested associations between EE and psychological distress in the context of breast cancer. These results encourage pursuing investigations in this direction. In addition the associations between the patient’s EE and physical problems related to the operation may support the idea to examine the question of whether the EE of the patient and of the partner can affect the course and outcome of the illness.

RESEARCH IMPLICATIONS: This project demonstrated how the EEconstruct initially developed to be used in the psychiatric context could be adapted to medical conditions. Furthermore this study examined as well the EE of the partner as the EE of the patient. Indeed so far studies have only focused on the partner’s EE. CLINICAL IMPLICATIONS: Results of the study will be useful for the development of psychosocial interventions for the patients and their partner. The association between patient’s psychological distress and HEE of each partner talks for a double intervention: 1) an individual one in couples with a HEE women (focusing on the own attitude and emotional-cognitive perspective) and/or 2) a couple-oriented one in couples with a HEE partner.

ACKNOWLEDGEMENT OF FUNDING: This project benefited from the support of the Swiss National Centre of Competence in Research LIVES – Overcoming vulnerability: life course perspectives, which is financed by the Swiss National Science Foundation.

Citation Key1029
Refereed DesignationRefereed

The contribution of attachment to psychological adjustment in women facing breast cancer

TitleThe contribution of attachment to psychological adjustment in women facing breast cancer
Publication TypeJournal Article
Year of Publication2013
AuthorsCairo Notari, S, Favez, N, Charvoz, L, Notari, L, Panes-Ruedin, B, Delaloye, J-F
JournalPsycho-Oncology
Volume22
NumberSuppl. 3
Pagination347-348
Abstract

BACKGROUND: Attachment theory provides a general model for understanding the way individuals emotionally react when stressed. Two main dimensions of attachment have been identified: anxiety (to exacerbate the emotional needs and dependence to others) and avoidance (to downplay threat and distress).This study examines the association between treatment-related physical symptoms of breast cancer, anxious or avoidant attachment, and psychological distress in women.

METHOD: This study is part of a larger project on the role of social support in women facing cancer. Women were recruited during hospitalisation at the Breast Centre of the University Hospital of Lausanne. For this study, we used data from 72 women. Their mean age is 53.73 (SD = 12.17). After surgery, women completed the following self-reported questionnaires: the European Organization for Research and Treatment of Cancer (EORTC-QLQ BR23) for physical symptoms; the Experiences in Close Relationships-revised (ECR-R) for adult attachment; and the Brief Symptoms Inventory (BSI-18) for psychological distress. Several socio-demographic and medical data were used as control variables.

RESULTS: Different multiple regression models have been tested to examine the link between physical symptoms, attachment styles and psychological distress. Contrarily to our hypothesis, anxiety does not moderate but instead directly predicts distress. On the contrary, avoidant attachment has a moderating effect on the link between physical symptoms and distress. Nevertheless, the best-fit model includes physical symptoms, anxious attachment and neoadjuvant treatment (control variable) as predictors; this model accounts for 50.7% of the variance in distress. In this model no direct nor moderating effect for avoidant attachment was found. CONCLUSIONS: Our study shows that attachment plays a role in adjustment to breast cancer. This result demonstrates that women’s response to stress is not only determined by disease-specific variables but also by their general way of regulating emotions which is a trait of their personality. Interventions aiming at helping women to cope with breast cancer should take into account individual variability in emotion regulation to be more efficient.

ACKNOWLEDGEMENT OF FUNDING: This study benefited from the support of the Swiss National Centre of Competence in Research LIVES – Overcoming vulnerability: life course perspectives, which is financed by the Swiss National Science Foundation. The authors are grateful to the Swiss National Science Foundation for its financial assistance.

Citation Key1028
Refereed DesignationRefereed

Persönliche Bilanzierung der Herausforderungen einer Verwitwung im Zeit- und Geschlechtervergleich

TitlePersönliche Bilanzierung der Herausforderungen einer Verwitwung im Zeit- und Geschlechtervergleich
Publication TypeJournal Article
Year of Publication2013
AuthorsHöpflinger, F, Spahni, S, Perrig-Chiello, P
JournalZeitschrift für Familienforschung
Volume25
Number3
Pagination267-285
Keywordsgender differences, psychosocial challenges, time effects, widowhood
Abstract

Research on bereavement has traditionally focussed on widowhood as either a social or individual event, but rarely under both perspectives. Furthermore, little is known whether existing research results mirror period or cohort effects. The aim of this article is to investigate constancies and changes in the retrospective perception of the challenges of widowhood of elderly women and men living in different decades in Switzerland. Data stem from three questionnaire studies with 1,197 widowed men and women (aged 65-102 years) carried out in 1979, 1994, and 2011. Results reveal that the subjective interpretations mirror the significant improvement of the economic and social situation of widowed individuals in Switzerland over the last decades, particularly for women. In contrast, no significant time effects can be observed with regard to the psychological challenges of marital loss in old age (redefinition of sense of life, feelings of loneliness). These findings suggest, that even in good socio-economic conditions widowhood remains psychologically a critical life event.

Citation Key1025
Refereed DesignationRefereed

Social origins and post-high school institutional pathways: A cumulative dis/advantage approach

TitleSocial origins and post-high school institutional pathways: A cumulative dis/advantage approach
Publication TypeJournal Article
Year of Publication2014
AuthorsGiudici, F, Pallas, AM
JournalLIVES Working Papers
Volume2014
Issue30
Pagination1-26
PublisherNCCR LIVES
Place PublishedLausanne
ISSN2296-1658
Keywordscumulative advantage and disadvantage, life course pathways, sociology of education, transition out of high school
Abstract

The social stratification that takes place during the transition out of high school is traditionally explained with theoretical frameworks such as status attainment and social reproduction. In our paper, we suggest the cumulative dis/advantage hypothesis as an alternative theoretical and empirical approach that explains this divergence in institutional pathways as the result of the dynamic interplay between social institutions (in our case, schools) and individuals' resources.
We use data from the NLSY79 in order to compute institutional pathways (defined by educational and occupational status) of 9200 high school graduates. Optimal Matching Analysis and Cluster Analysis generated a typology of life course pathways. Our results show that both ascribed characteristics and students’ high school characteristics and resources are predictors of post-high school pathways.

DOI10.12682/lives.2296-1658.2014.30
Citation Key1024