Pilot randomized trial of an acceptance-based telehealth intervention for women with ovarian cancer and PARP inhibitor-related fatigue.

OBJECTIVE: Poly(ADP-ribose) polymerase inhibitors (PARPi) have dramatically changed treatment for advanced ovarian cancer, but nearly half of patients experience significant fatigue. We conducted a two-site pilot randomized trial to evaluate the feasibility, acceptability, and preliminary efficacy of a brief, acceptance-based telehealth intervention (REVITALIZE) designed to reduce fatigue interference in patients on PARPi. METHODS: From June 2021 to April 2022, 44 participants were randomized 1:1 to REVITALIZE (6 weekly one-on-one sessions+booster) or enhanced usual care. Feasibility was defined as: ≥50% approach-to-consent among potentially eligible patients and ≥70% completion of 12-week follow-up assessment; acceptance was <20% participants reporting burden and <20% study withdrawal. Fatigue, anxiety, depression, and quality of life were assessed at baseline, 4-, 8- and 12-weeks. RESULTS: Among 44 participants (mean age = 62.5 years, 81.8% stage III/IV disease), the study was feasible (56.4% approach-to-consent ratio, 86.3% completion of 12-week assessment) and acceptable (0% reporting burden, 11.3% study withdrawal). At 12-week follow-up, REVITALIZE significantly reduced fatigue interference (Cohen's d = 0.94, p = .008) and fatigue severity (d = 0.54, p = .049), and improved fatigue levels (d = 0.62, p = .04) relative to enhanced usual care. REVITALIZE also showed promise for improved fatigue self-efficacy, fatigue catastrophizing, anxiety, depression, and quality of life (ds = 0.60-0.86, p ≥ .05). Compared with enhanced usual care, REVITALIZE participants had fewer PARPi dose reductions (6.7% vs. 19.0%), and dose delays (6.7% vs. 23.8%). CONCLUSIONS: Among fatigued adults with ovarian cancer on PARPi, a brief, acceptance-based telehealth intervention was feasible, acceptable, and demonstrated preliminary efficacy in improving fatigue interference, severity, and levels. REVITALIZE is a novel, scalable telehealth intervention worthy of further investigation.

Relationship dissolution and psychopathology.

Studies using probability samples have yielded cross-sectional and longitudinal associations between relationship dissolution and psychopathology, including depressive, anxiety, and substance use symptoms and disorders. The present review summarizes theory relevant to the association of relationship dissolution to psychopathology, discusses the time course over which postdissolution psychopathology may be most likely to manifest, and selectively reviews empirical findings regarding main and moderated associations between relationship dissolution and psychopathology. We conclude by acknowledging the need for continued study of the association between relationship dissolution and psychopathology, including research that rules out potential rival explanations (i.e., confounding variables) for this association and examines this association across cultures and types of intimate relationships (e.g., cohabiting relationships).

Marital dissolution, marital discord, and C-reactive protein: Results from The Irish Longitudinal Study on Ageing.

OBJECTIVE: Inflammation is one biological pathway through which marital dissolution and marital discord may increase risk for chronic disease. The present study was conducted to investigate the cross-sectional association between marital dissolution, marital discord, and C-reactive protein (CRP), an indicator of inflammation, in a probability sample of Irish adults aged 50 years or older. METHOD: Data were drawn from The Irish Longitudinal Study on Ageing. Linear regression analyses were conducted to examine (a) the association between marital dissolution and CRP values (N = 2,545), (b) the association between marital discord and CRP values (N = 1,949), and (c) whether these associations were moderated by gender. Subsequent models adjusted for demographic characteristics and health variables. RESULTS: With respect to marital dissolution, individuals who were separated or divorced had significantly higher CRP relative to married individuals. With respect to marital discord, gender significantly moderated the association between marital discord and CRP, such that marital discord was significantly and positively associated with CRP for men, whereas this association was not statistically significant for women. Results for marital dissolution and marital discord remained statistically significant when adjusting for demographic characteristics and health variables. CONCLUSIONS: This is one of the first studies to document a significant cross-sectional association between marital dissolution, marital discord, and CRP, incremental to demographic and health covariates, in a non-American probability sample. Results indicate that inflammation may be one pathway by which marital dissolution and marital discord contribute to risk for disease and early death. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Associations Between Marital Discord and Depressive Symptoms: A Cross-Cultural Analysis.

The objectives of this study were to investigate actor and partner effects of the association between marital discord and depressive symptoms in a sample of 4,779 couples from 11 European countries that were divided into three groups (i.e., Northern, Central, Southern Europe), and evaluate the potential gender and cross-cultural invariance of this association. Actor-partner interdependence models were used to analyze the cross-sectional associations between self-reported perceived marital conflict and depressive symptoms. Marital conflict was significantly and positively associated with self-reported depressive symptoms for husbands and wives (actor effects), as well as with partner-reported depressive symptoms (partner effects). Pooling across cultural groups, no significant difference in the magnitude of actor or partner effects based on gender was found. The magnitude of the actor effects varied across cultural groupings only for women: a significantly weaker association existed for women residing in Northern Europe relative to women in Central or Southern Europe. These results suggest that marital discord is a reliable correlate of depressive symptoms for European couples and that the magnitude of the positive association varies by culture for women. Should these results be replicated longitudinally, couple-based interventions may be indicated to reduce marital discord and prevent and treat depression in Europe.

Los objetivos de este estudio fueron investigar los efectos en el actor y la pareja de la asociación entre el desacuerdo conyugal y los síntomas depresivos en una muestra de 4779 parejas de 11 países europeos que se dividieron en tres grupos (p. ej.: Europa septentrional, Europa Central y Europa meridional) y evaluar la posible invariancia intercultural y de género de esta asociación. Se utilizaron los modelos de interdependencia actor-pareja para analizar las asociaciones transversales entre el conflicto conyugal percibido y los síntomas depresivos autoinformados. El conflicto conyugal estuvo asociado considerable y positivamente con síntomas depresivos autoinformados para los esposos y las esposas (efectos en el actor), así como con síntomas depresivos informados por las parejas (efectos en la pareja). Al combinar los grupos culturales, no se encontró una diferencia significativa en la magnitud de los efectos en el actor o en la pareja sobre la base del género. La magnitud de los efectos en el actor varió entre grupos culturales solo en el caso de las mujeres: existió una asociación considerablemente más débil para las mujeres que viven en Europa septentrional respecto de las mujeres de Europa Central o Europa meridional. Estos resultados sugieren que los desacuerdos conyugales se correlacionan de manera fiable con los síntomas depresivos en las parejas europeas, y que la magnitud de la asociación positiva varía según la cultura en el caso de las mujeres. Si estos resultados se repitieran longitudinalmente, podrían indicarse intervenciones basadas en la pareja para disminuir el desacuerdo conyugal y prevenir y tratar la depresión en Europa.

Love and war: Prospective associations between relationship distress and incidence of psychiatric disorders in active-duty Army personnel.

Research with probability samples of civilians has found that marital distress is associated with incidence of several psychiatric disorders. However, there is little longitudinal research on marital distress and incidence of psychiatric disorders in military personnel. This study examined the prospective association between marital distress and incidence of major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder, posttraumatic stress disorder (PTSD), and substance use disorder in a probability sample of active-duty soldiers from the U.S. Army (N = 934). Results indicated that among individuals who did not meet diagnostic criteria for the associated disorder at baseline, marital distress at baseline was associated with 30-day incidence of MDE, GAD, and PTSD assessed 5 years later. These results support continued research on the role of marital distress and the onset and course of psychopathology in active-duty military personnel and suggest that couple-based interventions designed to prevent or reduce marital distress may be effective in the prevention and treatment of psychopathology in military personnel. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Couples in arms: Marital distress, psychopathology, and suicidal ideation in active-duty Army personnel.

Although distress in intimate relationships such as marriage is positively associated with psychiatric symptoms and disorders and suicidal ideation in probability samples of the civilian population in the United States, relatively little is known regarding these associations in probability samples of active-duty military personnel. The present study evaluated the association between marital distress and past-30-day prevalence of psychiatric disorders (i.e., mood, anxiety, and substance use disorders) and suicidal ideation in a sample of 8,669 married active-duty soldiers in the U.S. Army who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Results indicated that marital distress was significantly and positively associated with past-30-day prevalence of major depressive disorder, generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and substance use disorder, as well as past-30-day prevalence of suicidal ideation. These associations were incremental to shared associations with demographics and co-occurring psychiatric disorders. The findings support continued research on the association between relationship distress and psychopathology in active-duty service personnel, and suggest the potential utility of adapting existing, evidence-based couple interventions for the prevention and treatment of psychopathology or relationship distress, currently in use in veteran and civilian settings, for use with active-duty military personnel and their partners. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Media multitasking is associated with altered processing of incidental, irrelevant cues during person perception.

BACKGROUND: Media multitasking (MMT)-using and switching between unrelated forms of media-has been implicated in altered processing of extraneous stimuli, resulting in performance deficits. Here, we sought to extend our prior work to test the hypothesis that MMT might be associated with enhanced processing of incidental environmental cues during person perception. METHOD: We tested the relationship between individual differences in MMT and person perception, by experimentally manipulating the relevance of environmental cues that participants could use to make trait and personality judgements of an unfamiliar social target. Relevant environmental cues consisted of neat or messy arrangements of the target's belongings, whereas irrelevant cues consisted of similarly neat or messy arrangements of the testing room in which participants viewed a video of the target. RESULTS: In general, relevant cues affected ratings of the target's conscientiousness. Additionally, and consistent with our hypothesis, there was a significant interaction between irrelevant cue condition and MMT, such that high media multitaskers more readily incorporated irrelevant environmental cues into their evaluations of the target's conscientiousness. CONCLUSIONS: These results suggest that high media multitaskers are more responsive to irrelevant environmental cues, which in turn can lead them to form inaccurate impressions of others.

Marital satisfaction and mortality in the United States adult population.

OBJECTIVE: The present study examined the association between marital satisfaction and all-cause mortality in a large, representative sample of American adults. Gender was evaluated as a potential moderator of this association. METHOD: Ratings of marital satisfaction from married adults <90 years of age (N = 19,246) were extracted from the 1978 - 2010 waves of the General Social Survey and linked to mortality data from the National Death Index. Discrete-time survival analysis was used to evaluate the association between marital satisfaction and mortality. RESULTS: After statistically adjusting for demographic variables, the odds of dying for married individuals who described their marriage as very happy or pretty happy were significantly lower than the odds of dying for married individuals who described their marriage as not too happy. The association between marital satisfaction and mortality was not moderated by gender. CONCLUSIONS: The significant prospective association between marital satisfaction and mortality suggests that reducing marital dissatisfaction may increase longevity. Further longitudinal research is warranted to (a) replicate the current findings, and (b) evaluate whether increasing marital satisfaction through clinical intervention increases longevity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Family communication with teens at clinical high-risk for psychosis or bipolar disorder.

Previous research has found that family problem-solving interactions are more constructive and less contentious when there is a family member with bipolar disorder compared with schizophrenia. The present study extended this research by examining whether family problem-solving interactions differ between clinical high-risk (CHR) stages of each illness. Trained coders applied a behavioral coding system (O'Brien et al., 2014) to problem-solving interactions of parents and their adolescent child, conducted just prior to beginning a randomized trial of family-focused therapy. The CHR for psychosis sample included 58 families with an adolescent with attenuated positive symptoms, brief intermittent psychosis, or genetic risk and functional deterioration; the CHR for bipolar disorder sample included 44 families with an adolescent with "unspecified" bipolar disorder or major depressive disorder and at least one first or second degree relative with bipolar I or II disorder. When controlling for adolescent gender, age, functioning, and parent education, mothers of youth at CHR for psychosis displayed significantly more conflictual and less constructive communication than did mothers of youth at CHR for bipolar disorder. Youth risk classification did not have a significant relationship with youths' or fathers' communication behavior. The family environment among help-seeking adolescents may be more challenging for families with an adolescent at CHR for psychosis compared with bipolar illness. Accordingly, families of adolescents at clinical high-risk for psychosis may benefit from more intensive or focused communication training than is required by families of adolescents at clinical high-risk for bipolar disorder or other mood disorders. (PsycINFO Database Record