H1N1 was not all that scary: uncertainty and stressor appraisals predict anxiety related to a coming viral threat.

H1N1 reached pandemic proportions in 2009, yet considerable ambivalence was apparent concerning the threat presented and the inclination to be vaccinated. The present investigation assessed several factors, notably appraisals of the threat, intolerance of uncertainty, and familiarity with the virus, that might contribute to reactions to a potential future viral threat. Canadian adults (N = 316) provided with several scenarios regarding viral threats reported moderate feelings of anxiety, irrespective of whether the viral threat was one that was familiar versus one that was entirely unfamiliar to them (H1N1 recurrence, H5N1, a fictitious virus: D3N4). Participants appraised the stressfulness of the threats to be moderate and believed that they would have control in this situation. However, among individuals with high intolerance of uncertainty, the viral threat was accompanied by high levels of anxiety, which was mediated by aspects of appraisals, particularly control and stressfulness. In addition, among those individuals that generally appraised ambiguous life events as being stressful, the viral threat appraisals were accompanied by still greater anxiety. Given the limited response to potential viral threats, these results raise concerns that the public may be hesitant to heed recommendations should another pandemic occur.

The 2009 H1N1 Influenza Pandemic: the role of threat, coping, and media trust on vaccination intentions in Canada.

Swine flu (H1N1) reached pandemic proportions in 2009, yet ambivalence was met concerning intentions to be vaccinated. The present investigation determined predictors of perceived H1N1 contraction risk and vaccination intentions among Canadian adults (N = 1,027) responding to an online questionnaire. The relatively low rate of vaccination intent (30.12%, and 34.99% being unsure of their intent) was related to a sense of invulnerability regarding illness contraction and symptom severity. Most individuals were skeptical that H1N1 would be widespread, believing that less than 10% of the population would contract H1N1. Yet, they also indicated that their attitudes would change once a single person they knew contracted the illness. Also, worry regarding H1N1 was related to self-contraction risk and odds of individuals seeking vaccination. Moreover, vaccination intent was related to the perception that the threat was not particularly great, mistrust of the media to provide accurate information regarding H1N1, and whether individuals endorsed problem-focused versus avoidant coping strategies. Given the role media plays in public perceptions related to a health crisis, trust in this outlet and credibility regarding the threat are necessary for adherence to recommended measures to minimize health risk.

Everyday experiences of women posttreatment after breast cancer: the role of uncertainty, hassles, uplifts, and coping on depressive symptoms.

Considerable research has examined the experiences of women at risk, during diagnosis, and throughout treatment of breast cancer; however, less in known about these women posttreatment. Many women report dealing with extensive long-standing ailments such as lymphedema and fatigue, as well as a fear of illness recurrence. However, women posttreatment also report finding benefit and meaning from their cancer occurrence. These orthogonal outcomes may be related to the uncertainty an individual is able to tolerate. Thus, this online study examined Canadian women who completed treatment for breast cancer (n = 42), and women in a control condition (n = 42), responses to the daily experience of hassles and uplifts, intolerance of uncertainty, coping strategies, and depressive symptoms. Although depressive symptoms and daily hassles did not differ between the two groups of women, women with a previous cancer experience reported a greater amount and frequency of daily uplifts, and hassle intensity predicted fewer depressive symptoms among women posttreatment compared to healthy controls. Furthermore, hassle intensity mediated the relationship between intolerance of uncertainty and depressive symptoms, but only for women in the control condition. Last, for women posttreatment only, the use of emotion-focused coping to deal with a fear of cancer recurrence mediated the relationship between intolerance of uncertainty and depressive symptoms, whereas problem-focused, avoidant, or cognitive-restructuring coping strategies did not. These results point to the need to provide resources to women posttreatment, but also that those women who survive breast cancer can obtain benefits from the experience.

Trust in physician in relation to blame, regret, and depressive symptoms among women with a breast cancer experience.

Following a diagnosis of breast cancer women experience considerable distress and often present with elevated symptoms of depression. A woman's relationship with her oncologist, and particularly trust in the physician, might influence depressive symptoms, as well as emotional and cognitive reactions to medical decisions made concerning treatment. To assess these relationships, women currently undergoing treatment for breast cancer (n = 40) and women who had previously been treated for breast cancer (n = 74) were asked about (1) trust in their physician, (2) who they blamed for negative events during treatment, (3) who made the treatment decisions, (4) regret, and (5) depressive symptoms. As well, community participants (n = 146) without breast cancer were asked about trust in their physician, levels of depression, and questions regarding blame if they hypothetically had breast cancer. Depression was greatest among women in treatment, and trust in physician was greatest among women posttreatment. However, trust in physician was neither related to depressive symptoms, decision making, nor responsibility for presence of metastases/relapse. Paradoxically, greater trust in physician was related to increased blame of the doctor for other negative events that had occurred. Furthermore, depressive scores were higher among women who blamed their doctor for negative events in comparison to women who ascribed blame to no one. As well, individuals who blamed themselves for negative events reported greater regret than individuals who blamed no one. Thus, though a woman may not hold her physician directly responsible for health outcomes, this relationship may be important to consider in other aspects of her psychological well-being.