Subjects were divided into information seekers (high monitors)/information avoiders (low monitors) and distractors (high blunters)/nondistractors (low blunters) on the basis of their scores on a self-report scale to measure coping styles, the Miller Behavioral Style Scale (MBSS). In Experiment 1, subjects were faced with a physically aversive event (the prospect of electric shock). High monitors and low blunters chose to seek out information about its nature and onset whereas low monitors and high blunters chose to distract themselves. This effect was strongest with the blunting dimension. High monitoring and low blunting were also accompanied by sustained high anxiety and arousal. In contrast, low monitors and high blunters were able to relax themselves over time. In Experiment 2, subjects worked on a series of tests that presumably predicted success in college. They could attend as often as they wished to a light that signaled how well they were performing. Results showed that coping-style scores accurately predicted informational strategy, particularly with the monitoring dimension: High monitors tended to look at the light whereas low monitors tended to ignore it. Thus the MBSS measure of coping styles appears to be a valid instrument for predicting behavioral strategies in response to both physical and psychological stressors. The theoretical and practical implications of these findings are discussed.
IMPORTANCE Cancer-related fatigue (CRF) remains one of the most prevalent and troublesome adverse events experienced by patients with cancer during and after therapy. OBJECTIVE To perform a meta-analysis to establish and compare the mean weighted effect sizes (WESs) of the 4 most commonly recommended treatments for CRF—exercise, psychological, combined exercise and psychological, and pharmaceutical—and to identify independent variables associated with treatment effectiveness. DATA SOURCES PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane Library were searched from the inception of each database to May 31, 2016. STUDY SELECTION Randomized clinical trials in adults with cancer were selected. Inclusion criteria consisted of CRF severity as an outcome and testing of exercise, psychological, exercise plus psychological, or pharmaceutical interventions. DATA EXTRACTION AND SYNTHESIS Studies were independently reviewed by 12 raters in 3 groups using a systematic and blinded process for reconciling disagreement. Effect sizes (Cohen d) were calculated and inversely weighted by SE. MAIN OUTCOMES AND MEASURES Severity of CRF was the primary outcome. Study quality was assessed using a modified 12-item version of the Physiotherapy Evidence-Based Database scale (range, 0–12, with 12 indicating best quality). RESULTS From 17 033 references, 113 unique studies articles (11525 unique participants; 78% female; mean age, 54 [range, 35–72] years) published from January 1, 1999, through May 31, 2016, had sufficient data. Studies were of good quality (mean Physiotherapy Evidence-Based Database scale score, 8.2; range, 5–12) with no evidence of publication bias. Exercise (WES, 0.30; 95% CI, 0.25–0.36; P < .001), psychological (WES, 0.27; 95% CI, 0.21–0.33; P < .001), and exercise plus psychological interventions (WES, 0.26; 95% CI, 0.13–0.38; P < .001) improved CRF during and after primary treatment, whereas pharmaceutical interventions did not (WES, 0.09; 95% CI, 0.00–0.19; P = .05). Results also suggest that CRF treatment effectiveness was associated with cancer stage, baseline treatment status, experimental treatment format, experimental treatment delivery mode, psychological mode, type of control condition, use of intention-to-treat analysis, and fatigue measures (WES range, −0.91 to 0.99). Results suggest that the effectiveness of behavioral interventions, specifically exercise and psychological interventions, is not attributable to time, attention, and education, and specific intervention modes may be more effective for treating CRF at different points in the cancer treatment trajectory (WES range, 0.09–0.22). CONCLUSIONS AND RELEVANCE Exercise and psychological interventions are effective for reducing CRF during and after cancer treatment, and they are significantly better than the available pharmaceutical options. Clinicians should prescribe exercise or psychological interventions as first-line treatments for CRF.
Background. Two main psychologic coping styles for dealing with cancer and other health threats have been identified: monitoring (attending to) or blunting (avoiding) potentially threatening information. This article reviews results and implications from this research relevant to cancer screening and management. Methods. The Monitor‐Blunter Style Scale has been used extensively to assess and categorize patients with regard to these coping styles to predict their differential responses to various cancer‐related screening and management regimens. Results. Patients characterized by a monitoring coping style generally are more concerned and distressed about their cancer risk, experience greater treatment side effects, are more knowledgeable about their medical situation, and are less satisfied with and more demanding about the psychosocial aspects of their care. They also prefer a more passive role in clinical decision making, are more adherent to medical recommendations, and manifest greater psychologic morbidity in response to cancer‐related threats. Conclusions. Patients fare better (psychologically, behaviorally, and physiologically) when the information they receive about their medical condition is tailored to their own coping styles: generally those with a monitoring style tend to do better when given more information, and those with a blunting style do better with less information. However, patients with a monitoring style who are pessimistic about their future or who face long term, intensely threatening, and uncontrollable medical situations may require not just more information, but also, more emotional support to help them deal with their disease. Cancer 1995; 76:167–77.
This study explored the interacting effects of personal dispositions and situational conditions on the stress response. Forty gynecologic patients about to undergo a diagnostic procedure (colposcopy) were divided into information seekers (monitors) and information avoiders (blunters). Half in each group were exposed to voluminous preparatory information, and half to the usual low level of information. Subjective, physiological, and behavioral measures of arousal and discomfort were obtained before, during, and after the procedure. Overall, low-information patients expressed less subjective arousal than high-information patients, and blunters showed less subjective and behavioral arousal than monitors. In addition, patients' level of psychophysiological arousal was lower when the level of preparatory information was consistent with their coping style; that is, blunters were less aroused with low information and monitors were less aroused with high information. Further evidence was gained for the utility and validity of a new scale for identifying monitors and blunters.
Attention to the psychological aspects of breast cancer risk will be critical in the development of risk-counseling programs that incorporate testing for the recently cloned breast cancer susceptibility gene, BRCA1 (and BRCA2 when that gene has also been cloned).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.