Prevalence and frequency of self-management strategies among female cancer survivors: the neglected roles of social relations and conscious living.

OBJECTIVE: To assess prevalence and frequency of use of self-management strategies among female cancer survivors and to empirically identify categories of self-management. METHODS: Female cancer survivors (N=673, mean age 51 years; >90% with breast cancer; M=5 years since diagnosis) completed an Internet survey indicating the frequency (never to very often) with which they had employed each strategy since diagnosis. The survey included commonly assessed self-management strategies, such as complementary and alternative medicine (CAM), religious practices, and exercise. Additionally we assessed the use of further strategies identified from recommendations of cancer survivors shared in Internet forums. RESULTS: A principal component analysis yielded five categories: More Conscious Living, Turning to Family/Friends, CAM, Religious/Spiritual Practices, and Exercise. Prevalence rates of commonly measured strategies like CAM, Religious Practices, and Exercise were similar to previous studies. Considering frequency of use, however, revealed that only few participants reported frequent use of these strategies (<10%). In contrast, about half of the women (>50%) reported Turning to Family/Friends and engaging in More Conscious Living strategies (very) often. CONCLUSIONS: Relying on prevalence assessments of commonly investigated behaviors such as CAM or exercise may overestimate their use among cancer survivors. Cancer survivors engage in a wide range of self-management strategies. Encouraging living more consciously and cultivating social relations might be of greater relevance compared with CAM use or exercise.

"Don't Drink Too Much!" Reactance Among Young Men Following Health-Related Social Control.

This study investigated conditions under which young men responded with reactance to the suggestion to reduce their alcohol consumption. In an experimental study, 84 young men (university students, mean age: 24 years) listened to a recorded telephone call and were asked to imagine that they themselves were the recipients of this call. In this call, either a girlfriend or a male friend suggested that the recipient of the call should reduce his alcohol intake that evening. In one condition, the suggestion was highly restrictive; in the other condition, the suggestion was framed in a nonrestrictive way. Perceived threat, negative thoughts, and feelings of anger after listening to the call were assessed. Further outcome variables were intention and perceived probability of complying with the suggestion. Participants felt more anger after hearing the highly restrictive suggestion and more threatened by the suggestion made by the girlfriend. Interaction effects emerged. Participants reported more negative thoughts and lower intention and perceived probability to comply when a highly restrictive suggestion was made by the girlfriend. The male friend's highly restrictive suggestion resulted in a perceived probability of complying (54%) that was similar to the probability of the girlfriend's nonrestrictive suggestion (55%). Women's efforts to reduce their male partners' alcohol consumption can result in boomerang effects. Male peers might be more effective in motivating other men to behave in a healthier way. These results support recent findings with regard to the potential of peer positive social control.

Cognitive-Behavioral and Psychodynamic Therapy in Female Adolescents With Bulimia Nervosa: A Randomized Controlled Trial.

OBJECTIVE: The authors compared cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) for the treatment of bulimia nervosa (BN) in female adolescents. METHOD: In this randomized controlled trial, 81 female adolescents with BN or partial BN according to the DSM-IV received a mean of 36.6 sessions of manualized disorder-oriented PDT or CBT. Trained psychologists blinded to treatment condition administered the outcome measures at baseline, during treatment, at the end of treatment, and 12 months after treatment. The primary outcome was the rate of remission, defined as a lack of DSM-IV diagnosis for BN or partial BN at the end of therapy. Several secondary outcome measures were evaluated. RESULTS: The remission rates for CBT and PDT were 33.3% and 31.0%, respectively, with no significant differences between them (odds ratio [OR] = 0.90, 95% CI = 0.35-2.28, p = .82). The within-group effect sizes were h = 1.22 for CBT and h = 1.18 for PDT. Significant improvements in all secondary outcome measures were found for both CBT (d = 0.51-0.82) and PDT (d = 0.24-1.10). The improvements remained stable at the 12-month follow-up in both groups. There were small between-group effect sizes for binge eating (d = 0.23) and purging (d = 0.26) in favor of CBT and for eating concern (d = -0.35) in favor of PDT. CONCLUSION: CBT and PDT were effective in promoting recovery from BN in female adolescents. The rates of remission for both therapies were similar to those in other studies evaluating CBT. This trial identified differences with small effects in binge eating, purging, and eating concern. Clinical trial registration information-Treating Bulimia Nervosa in Female Adolescents With Either Cognitive-Behavioral Therapy (CBT) or Psychodynamic Therapy (PDT). http://isrctn.com/; ISRCTN14806095.