Cancer coping self-efficacy mediates the relationship between mental adjustment to cancer and health-related quality of life in persons with cancer

Individuals with cancer experience significant levels of distress. Improving health-related quality of life of persons with cancer is a major focus in cancer treatment. This study investigated the mediating role of self-efficacy for coping with cancer in the relationship between mental adjustment to cancer and health-related quality of life among individuals with cancer. Two hundred and fourteen persons with cancer (male = 74, female = 140, mean age = 50.57) were recruited from a University Teaching Hospital, in South-West Nigeria. Participants responded to the measures of psychological responses to cancer (mental adjustment to cancer), self-efficacy for coping with cancer (Cancer Behaviour Inventory [CBI]), and health-related quality of life (Functional Assessment of Cancer Therapy–General). Mediation analysis and structural equation modelling were carried out using IBM AMOS software version 23. Domains of mental adjustment to cancer significantly predicted health-related quality of life, helplessness/hopelessness, and anxious preoccupation had a negative association with health-related quality of life; whereas fighting spirit, cognitive avoidance, and fatalism were positively associated with health-related quality of life. Self-efficacy had a positive association with health-related quality of life. Mediation analysis showed that self-efficacy for coping with cancer partially mediated the association between four domains of mental adjustment to cancer (helplessness/hopelessness, fighting spirit, cognitive avoidance, and fatalism) and health-related quality of life. The findings demonstrated the need for improved coping mechanisms while undergoing cancer treatment. The study has important clinical implications for psycho-oncology practice, particularly with respect to self-efficacy for coping with cancer. Psychosocial therapies aimed at enhancing the self-efficacy of persons with cancer should be incorporated as part of cancer treatment to improve their health-related quality of life.

Inflammatory Bowel Disease-related Behaviours [IBD-Bx] questionnaire: Development, validation, and prospective associations with fatigue

Background and Aims Disease-related behaviours that may maintain or worsen symptom burden remain largely unexplored in inflammatory bowel disease (IBD). In this study, we developed and validated an instrument assessing IBD-related, modifiable behaviours and explored which behaviours prospectively correlate with fatigue, a debilitating and common symptom in IBD. Methods Initially, 72 items reflecting IBD-related behaviours were generated based on literature review and input from clinicians and people diagnosed with IBD. During wave 1, 495 IBD patients rated to what extent each behaviour was applicable to them. Additionally, disease activity, fatigue, IBD-related concerns, and psychological variables were assessed. During a follow-up visit 4-12 weeks later (wave 2), a random selection of 92 patients from wave 1 completed the measures assessing the IBD-related behaviours, disease activity, and fatigue once more. Results A principal component analysis with oblique rotation revealed seven components in the 72 IBD behaviours, which could be interpreted as: (1) Avoiding food and activities, (2) Access to toilets, (3) Avoidance of sex, (4) Cognitive avoidance, (5) Not sharing with others, (6) Alternative treatments, and (7) Disease management. Each component was reduced to 3-5 representative items, resulting in a final, 25-item IBD-Bx questionnaire showing good concurrent validity (alphas > .63) and reliability. Almost all components were cross-sectionally related to levels of fatigue. Avoiding Food and Activities and Access to Toilets significantly predicted fatigue at wave 2 when controlling for baseline fatigue. Conclusions The IBD-Bx is a valid and reliable questionnaire of IBD-related behaviours, some of which predict future fatigue burden.

Listening Boredom, Listening Boredom Coping Strategies, and Listening Performance: Exploring the Possible Relationships in Saudi EFL Context

Researchers paid ample attention to an important variable called boredom in numerous contexts; however, limited research exists regarding the association of boredom with listening comprehension performance in EFL settings. Thus, the current study aims to establish the association between listening boredom and listening comprehension performance by deploying listening boredom coping strategies as a mediating construct. A quantitative research approach, and a cross-sectional and correlational research design was used to conduct this study. A listening comprehension test and questionnaires were used to gather the data from 313 Saudi EFL learners. Results directed that there exists a negative yet significant association between listening boredom and listening comprehension performance. In addition, listening boredom showed a positive and significant association with all of the four listening boredom coping strategies. Furthermore, three out of four listening boredom coping strategies (i.e., behavioral, cognitive, and behavioral avoidance) showed a positive and significant association with listening performance; however, cognitive avoidance strategies showed a significant yet negative association with listening comprehension performance. Lastly, results regarding mediation indicated that listening boredom coping strategies mediated the relationship between listening boredom and listening comprehension performance. Based on the results, various recommendations were presented to EFL learners, instructors, and policymakers.

Validation of Mini-Mental Adjustment to Cancer scale in a Moroccan sample of breast cancer women

Background The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) instrument is commonly used worldwide by professionals of oncology, but the scale has not, up to date, been validated in Arabic and Moroccan context, and there is an absence of data in the Moroccan population. This study aims to validate the Mini-MAC, translated and adapted to the Arabic language and Moroccan culture, in women with breast cancer. Methods Data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 158). Then, this structure was confirmed in the validation sample (N = 203) using confirmatory factor analysis (CFA). Results Confirmatory factor analysis confirmed Watson’s original structure underlying the Mini-MAC items: Helpless/Hopeless, Anxious Preoccupation, Fighting Spirit, Cognitive Avoidance, and Fatalism. Absolute, incremental, and parsimonious fit indices showed a highly significant level of acceptance confirming a good performance of the measurement model. The instrument showed sufficient reliability and convergent validity demonstrated by acceptable values of composite reliability (CR =0.93–0.97), and average variance extracted (AVE = 0.66–0.93), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio of correlations values were lesser than 0.85, indicating acceptable discriminant validity. Conclusions reliability; and both convergent and discriminant validity tests indicated that the Arabic version of the Mini-MAC had a good performance and may serve as a valid tool measuring psychological responses to cancer diagnosis and treatment.

Countering Avoidant Behaviors

The key concept for this session is emotion avoidance, which means any strategies we use to avoid feeling strong emotions or to prevent our emotions from becoming more intense. Although these responses may be useful in some situations, they rarely work well in the long term, and they can increase the intensity of our emotions when we encounter a similar situation in the future. During this session, clients learn how suppression of thoughts and emotions can be counterproductive. Clients are taught to identify three types of avoidance, which are behavioral avoidance (obvious and subtle), cognitive avoidance, and safety signals.

Therapist Materials for Countering Avoidant Behaviors

The session in this chapter looks at how suppression of thoughts and emotions can be counterproductive. Suppression or attempted avoidance may control things somewhat in the short term but rarely works in the long term, and it increases intensity of emotion when a similar situation is encountered in the future. Subtle behavioral avoidance, cognitive avoidance, and safety signals are introduced, and clients are asked to provide their own examples. Habitual avoidance of emotion creates negative messages about our capabilities and robs us of the chance to learn that the emotion is tolerable and will pass on its own without our efforts to avoid or escape. In this countering avoidant behavior session, clients are taught how to do the opposite of avoidance by developing a willingness to lean into emotions, or approach them, and thereby learn new lessons about emotion, situations, and themselves.

University Students' Multidimensional State Boredom and Strategies to Cope with Classroom Boredom

This study sought to examine how university students' state boredom dimensions (i.e., disengagement, high arousal, low arousal, inattention, and time perception) and their boredom coping strategies (i.e., cognitive approach, behavioral approach, cognitive avoidance, and behavioral avoidance) in the classroom are mediated in relation to gender and academic year. A total of 186 undergraduate students from a Turkish university, majoring in English language teaching in the faculty of education voluntarily participated in the study. The results indicated that the male participants experienced higher levels of boredom than the females in all levels of the state boredom. Additionally, the females had more inclination to use cognitive approach, while the male participants exhibited more behavioral approach to cope with boredom. Secondly, the participants with different academic levels only scored differently in disengagement, a state boredom dimension, and in cognitive approach, a boredom coping strategy. The findings highlight the significance of identifying student boredom and thereby specifying strategies to relieve their boredom in the classroom. Indeed, by gaining a proper understanding of the reactions triggered by boredom in classes, we would be able to spot the developmental paths of these reactions and thereby adopt the necessary measures to deal with student boredom.

Coping Strategies by University Students in Response to COVID-19: Differences between Community and Clinical Groups

Last year, the COVID-19 pandemic had severe consequences on the health and well-being of millions of people. Different studies try to identify the main effects that the crisis and several lockdowns have had on the citizens’ mental health. This research analyses the coping strategies generated by students from a community group and a clinical group in response to this crisis, using the Coping Responses Inventory—Adult Form (CRI-A) by Moos with a sample of 1074 students of Universidad de Extremadura. Multivariate analysis and receiver operating characteristic curve analysis have been carried out, revealing, amongst other things, a greater predisposition of the clinical sample towards factors such as seeking guidance and support, cognitive avoidance or emotional discharge. Results show that students with prior mental health problems perform an unhealthy coping response based on avoidance strategies. This group of students suffers a double source of distress and anxiety, one derived from their prior psychopathologic problems and the stress of the lockdown and another one originating from an inefficient coping response, which makes coping strategies raise levels of distress and anxiety.

Effects of Schema Therapy on Anxiety, Cognitive Avoidance, and Resilience in Couples With Conflicts

Background: Resilience, as a variable affecting couples’ relationships and resolving conflicts between them, plays an essential role in family psychology and family therapy. Materials & Methods: This was a quasi-experimental study with a pre-test, post-test, a control group, and a 45-day follow-up design. The statistical population included all couples with low marital adjustment who were referred to the psychological counseling centers of Ahvaz City, Iran, in 2020. Thirty participants were selected using the convenience sampling method and randomly divided into the experimental and control groups (n=15 couples/group). The necessary data were collected using the Symptom Checklist-90-Revised (SCL-90-R), the Cognitive Avoidance Questionnaire (CAQ), and the Connor-Davidson Resilience Scale (CD-RISC). The schema therapy program was performed for the experimental group in eight 90-minute weekly sessions; however, the control group received no intervention. The follow-up phase was performed after 45 days. Repeated-Measures Analysis of Variance (ANOVA) was used in SPSS to analyze the obtained data. Results: Schema therapy effectively decreased anxiety and cognitive avoidance and increased resilience among couples in the experimental group (P<0.001). The Mean±SD post-test score of resilience was measured as 50.87±4.64 in the experimental group, which increased, compared to the post-test scores (43.33±5.71) in the control group. Conclusion: Schema therapy decreased anxiety, cognitive avoidance, and significantly increased resilience in the examined couples. Schema therapy can be used to improve resilience in couples presenting marital conflicts.