Psychological distress in cancer is a well-documented phenomenon, but additional information is needed about demographic and disease correlates in diverse populations with different forms of cancer. This study focused on gynecologic cancers. Using the Distress Thermometer and the Hospital Anxiety and Depression Scale, this study examined distress levels in 94 women with gynecologic cancer who were being treated as outpatients at a large urban medical center. The distress levels in this sample were lower than in comparable studies, raising questions about openness to reporting distress. Those who reported higher levels of distress were more likely to also report a mental health diagnosis or psychiatric medication. This suggests that an alternate form for distress screening may involve inquiring about mental health treatment. In this sample, younger women and those with higher educational achievement or private health insurance had higher levels of distress. Conversely, there were no relations between distress levels and disease characteristics, indicating that, for example, women with early stage disease have just as much risk of distress as those with later-stage disease.

Individuals' attachment styles have been traced throughout the life span, informing our understanding of long-standing interpersonal patterns and self-care habits. Recent scholarship has identified direct and indirect mechanisms through which attachment theory may impact individuals' health outcomes, with specific emphasis on endocrine and behavioral responses to stress. This article reviews extant literature on medical patients' attachment styles and also proposes a new line of research: an investigation of the interaction between patients' and providers' attachment styles. As medical establishments place more emphasis on effective patient-provider communication, attachment theory serves as an apt framework for clarifying, measuring, and training medical personnel in the advancement of patient-centered care.From birth, we are genetically wired to attach to our caregivers for survival. These first relationships not only shape expectations for the self and for future relationships, but they also shape the organization of the brain, nervous system, and endocrine system. In other words, how we attach to others in early childhood can affect how we develop interpersonally and biologically throughout the life

Studies of psychological morbidity and quality of life in ovarian cancer (OC) patients have largely relied on selfreport measures despite substantial research questioning the confounding effects of denial and self-deception in self-report scores. This study investigated the use of the Early Memory Index (EMI) for detection of psychological distress among OC patients. Early Memory Index outcomes of 77 OC outpatients were compared with high and low distress scores on the Center for Epidemiological Studies-Depression (CES-D) and State-Trait Anxiety Inventory Form-Y (STAI-S, STAI-T). A higher percentage of participants scored as distressed on the EMI (51%) than the CES-D (30%), STAI-S (16%), and STAI-T (21%). A sizable percentage (up to 48%) of low distress respondents on self-report measures demonstrated illusory mental health on the EMI. Results support earlier research demonstrating self-report scales' limitation detecting psychological distress and the possibility of the EMI as an alternative screening measure of psychological adjustment in OC patients. K E Y W O R D S distress screening, early memories, oncology, ovarian cancer

This method describes a statistical procedure to compare a single mean to its JAR scale mid-point. It will determine if a product attribute is perceived to be significantly different from the ideal. When an attribute is significantly different from the mid-point, conclusions can also be made about the direction of the difference. This analysis is designed to compare a single product/attribute combination to its center-point, and is not appropriate for the comparisons across products or attributes. Comparisons among multiple products in the same test are limited to statements as to how they each relate to the JAR scale mid-point or “Ideal” value. Note that the “Ideal” value refers to the JAR scale mid-point, and is not related to a specific gold standard product.

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