Diagnosis of life-threatening illness now meets Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) criteria for traumatic stressor exposure for posttraumatic stress disorder (PTSD). Quality of life (QOL) and PTSD-like symptoms were assessed in 55 women posttreatment for breast cancer. PTSD symptom measures included the PTSD Checklist--Civilian Version (PCL-C) and the Impact of Events Scale. QOL was assessed using the 20-item Medical Outcomes Study Questionnaire. PTSD symptomatology was negatively related to QOL, income, and age. Time since treatment, type of cytotoxic treatment, and stage of disease were unrelated to PTSD symptoms. With suggested criteria for the PCL-C, 5% to 10% of the sample would likely meet DSM-IV PTSD criteria. Findings suggest that in survivors of breast cancer, these symptoms might be fairly common, may exceed the base rate of these symptoms in the general population, are associated with reports of poorer QOL, and, therefore, warrant further research and clinical attention.

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Objective This article reviews recent literature on adults’ quality of life following hematopoietic stem cell transplantation (HSCT). Methods We identified 22 prospective reports with at least 20 participants at baseline through a search of databases (Medline and PsycInfo) and handsearching of articles published from 2002 to October 2007. If longitudinal data were not available or were scarce for a particular topic or time point, cross-sectional studies were reviewed. Results Although physical, psychological, and social aspects of quality of life tend to improve during the years following transplantation, a significant proportion of HSCT survivors experience persistent anxiety and depressive symptoms, fatigue, sexual dysfunction, and fertility concerns. Despite ongoing treatment side effects, the majority of HSCT survivors resume their work, school, or household activities. Conclusion We conclude that theory-driven research with larger samples is needed to identify subgroups of HSCT survivors with adjustment difficulties. Such research would examine survivors’ evolving standards and definitions of quality of life to improve the accuracy and meaningfulness of assessment and incorporate biological, psychological, and contextual factors that may contribute to positive adjustment.

Over the past two decades, hypnoanalgesia has been widely studied; however, no systematic attempts have been made to determine the average size of hypnoanalgesic effects or establish the generalizability of these effects from the laboratory to the clinic. This study examines the effectiveness of hypnosis in pain management, compares studies that evaluated hypnotic pain reduction in healthy volunteers vs. those using patient samples, compares hypnoanalgesic effects and participants' hypnotic suggestibility, and determines the effectiveness of hypnotic suggestion for pain relief relative to other nonhypnotic psychological interventions. Meta-analysis of 18 studies revealed a moderate to large hypnoanalgesic effect, supporting the efficacy of hypnotic techniques for pain management. The results also indicated that hypnotic suggestion was equally effective in reducing both clinical and experimental pain. The overall results suggest broader application of hypnoanalgesic techniques with pain patients.

BACKGROUND Advanced lung cancer (LC) patients and their families report low self-efficacy for self-care/caregiving and high rates of distress, yet few programs exist to address their supportive care needs during treatment. OBJECTIVE This pilot study examined the feasibility, acceptability, and preliminary efficacy of a 6-session telephone-based dyadic psychosocial intervention that we developed for advanced LC patients and their caregivers. The program is grounded by Self-determination Theory (SDT), which emphasizes the importance of competence (self-efficacy), autonomy (sense of choice/volition), and relatedness (sense of belonging/connection) for psychological functioning. Primary outcomes were psychological functioning (depression/anxiety) and caregiver burden. Secondary outcomes were the SDT constructs of competence, autonomy, and relatedness. METHODS Thirty-nine advanced LC patients who were within one month of treatment initiation (baseline) and their caregivers (51% spouses/partners) completed surveys and were randomized to the intervention or usual medical care. Eight weeks post-baseline, they completed follow-up surveys. RESULTS Solid recruitment (60%) and low attrition rates demonstrated feasibility. Strong program evaluations (X̄=8.6 out of 10) and homework completion rates (88%) supported acceptability. Participants receiving intervention evidenced significant (p<.0001) improvements in depression, anxiety, and caregiver burden relative to usual medical care. Large effect sizes (d>1.2) favoring the intervention were also found for patient and caregiver competence and relatedness, and for caregiver autonomous motivation for providing care. CONCLUSION These findings support intervention feasibility, acceptability, and preliminary efficacy. By empowering families with skills to coordinate care and meet the challenges of LC together, this intervention holds great promise for improving palliative/supportive care services in cancer.