The importance of social relationships for brain tumor patients' quality of life: A case for the inclusion of the concept of disclosure in psycho-oncological care.

Purpose: Interpersonal factors are of major importance for cancer patients' physical and mental health. Brain tumor patients rank amongst those cancer patients with the highest psychosocial burden. Changes in language, cognition, and personality pose specific risk factors for impeding interpersonal functioning in this patient group. Despite this, role and relevance of social support including both supportive (e.g., emotional support) and detrimental interactions causing distress (e.g., critical remarks) are not well understood. Aims of this study were thus (1) to investigate the association of social support and patients' Health Related Quality of Life (HRQoL) and (2) to assess whether this relationship is mediated by the patients' disclosure behavior.Methods: Seventy-four ambulatory brain tumor patients (mean age 54 years; 58% women) completed the following self-report questionnaires: Illness-specific Social Support Scale (SSUK) for assessment of positive support and detrimental interactions, the Disclosure of Trauma Questionnaire (DTQ) for assessment of patients' disclosure behavior, and the Short-Form Health Survey (SF-8) for assessment of QoL.Findings: Detrimental social interactions were significantly related to patients' mental and physical well-being while positive support was not. Our results support a model in which patients perceiving detrimental social interactions show more difficulties in talking about illness-specific contents in a functional manner. This, in turn, was associated with a lower physical and mental HRQoL.Conclusions: This was the first study in which the close associations of detrimental social interactions, brain tumor patients' dysfunctional disclosure behavior and patients' mental as well as physical well-being were empiricially validated. Thus, dysfunctional disclosure behavior might pose a relevant therapeutic target when offering psycho-oncological support for brain tumor patients and their families.

PTSD severity among emergency personnel: An investigation based on the Ehlers and Clark cognitive model.

OBJECTIVE: The relevance of both cognitive and interpersonal processes in predicting adjustment to potentially traumatic events has been highlighted in the literature. The aim of the present study was to investigate whether dysfunctional disclosure mediates the relationship between excessive negative appraisals and posttraumatic stress disorder (PTSD) symptomatology that is proposed in the cognitive PTSD model of Ehlers and Clark (2000). METHOD: A sample of 134 emergency service workers was interviewed to gain in-depth information regarding their experience of potentially traumatic events, and the following social interactions. Additionally, participants responded to the Disclosure of Trauma Questionnaire, the Posttraumatic Cognitions Inventory, and the Impact of Event Scale-Revised. RESULTS: Bootstrap mediation analyses revealed that the effect of negative trauma related appraisals on PTSD symptoms is partly mediated by dysfunctional disclosure. In particular, the two aspects of dysfunctional disclosure "reluctance to talk" and "excessive emotional reactions during disclosure" were of relevance in this model. The results remained stable even when controlling for potentially relevant sociodemographic and situational characteristics. CONCLUSIONS: Our results stress the importance of not only cognitive factors, but also interpersonal behavior in the development and maintenance of PTSD symptoms because we identified interpersonal risk factors (i.e., dysfunctional communicative strategies) to be relevant for PTSD elevation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The role of disclosure attitudes in the relationship between posttraumatic stress disorder symptom severity and perceived social support among emergency service workers.

The social-interpersonal framework model of posttraumatic stress disorder (PTSD; Maercker and Horn, 2012) highlights the relevance of interpersonal factors in the development and maintenance of PTSD symptoms. Therefore, the present study examined the role of self-perceived disclosure abilities to elucidate the well-known link between PTSD symptom severity and social support. In a cross-sectional design, 131 emergency service workers completed the Impact of Event Scale (IES-R), the Disclosure of Trauma Questionnaire (DTQ) and the Social Acknowledgement Questionnaire (SAQ) as well as answering trauma-specific questions to provide in-depth information regarding their experiences in potentially traumatic incidents and subsequent social interactions. We reveal the predescribed association between PTSD symptom severity and social support. However, bootstrap mediation analyses reveal the self-referential perceptions of disclosure abilities, particularly a reluctance to talk, to fully account for the link between PTSD symptom severity and social acknowledgement. Our findings strongly support the relevance of the self-perceived disclosure abilities in the processing of traumatic events. A reluctance to speak is associated with more severe PTSD symptoms and with lower levels of social support; therefore, facilitating and encouraging disclosure in individuals who feel unable to disclose traumatic contents may be clinically relevant in preventing feelings of social disapproval and isolation.

Altitude, pasture type, and sheep breed affect bone metabolism and serum 25-hydroxyvitamin D in grazing lambs.

This study aimed to investigate the bone development of two mountain sheep breeds during natural summer grazing either in the lowlands or on different characteristic alpine pastures. Pasture types differed in topographic slope, plant species composition, general nutritional feeding value, Ca and P content, and Ca:P ratio of herbage. Twenty-seven Engadine sheep (ES) lambs and 27 Valaisian Black Nose sheep (VS) lambs were divided into four groups of 6 to 7 animals per breed and allocated to three contrasting alpine pasture types and one lowland pasture type. The lambs were slaughtered after 9 wk of experimental grazing. The steep alpine pastures in combination with a high (4.8) to very high (13.6) Ca:P ratio in the forage decreased total bone mineral content as measured in the middle of the left metatarsus of the lambs from both breeds, and cortical bone mineral content and cortical bone mineral density of ES lambs. Breed × pasture type interactions occurred in the development of total and cortical bone mineral content, and in cortical thickness, indicating that bone metabolism of different genotypes obviously profited differently from the varying conditions. An altitude effect occurred for 25-hydroxyvitamin D with notably higher serum concentrations on the three alpine sites, and a breed effect led to higher concentrations for ES than VS. Despite a high variance, there were pasture-type effects on serum markers of bone formation and resorption.

Activation of bronchial epithelial cells in smokers without airway obstruction and patients with COPD.

STUDY OBJECTIVE: The aim of this study was to investigate the basal level as well as the tumor necrosis factor (TNF)-alpha- and interferon (IFN)-gamma-induced expression and release of the neutrophil chemoattractants interleukin (IL)-8 and growth-related oncogene (GRO)-alpha in primary bronchial epithelial cells (PBECs) from smokers without airflow obstruction and patients with COPD. In addition, the expression of both TNF-alpha-receptor subtypes--p55 TNF-receptor subtype (TNF-R55) and p75 TNF-receptor subtype (TNF-R75)--was quantified in PBECs. DESIGN: PBECs from eight smokers without airflow limitation and eight patients with COPD were stimulated with 50 ng/mL of TNF and 200 U/mL of IFN-gamma for 4 h along with unstimulated time controls. The transcriptional expression and protein release were quantitatively assessed by means of real-time polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS: Basal level messenger RNA (mRNA) expression and protein release of IL-8 and GRO-alpha were not significantly different between both groups, although a trend toward higher IL-8 levels was seen in patients with COPD. TNF-alpha induced significantly higher mRNA amounts of IL-8 (p = 0.005) and GRO-alpha (p = 0.007) in patients with COPD. This was accompanied by higher protein release data for IL-8 (p = 0.005) and GRO-alpha (p = 0.007). IFN-gamma had no significant effect on the mRNA expression and protein release of IL-8 and GRO-alpha in either group. TNF-R55 and TNF-R75 were detectable in PBECs. However, no significant differences were found between both groups with respect to steady-state mRNA levels of TNF-alpha-receptor subtypes. CONCLUSION: PBECs from patients with COPD show significantly higher TNF-alpha-induced release of the neutrophil chemoattractant CXC-chemokines IL-8 and GRO-alpha compared to smokers without airflow limitation. This increased activation of PBECs may contribute to the predominance of neutrophils seen in the airway lumen of patients with COPD.