We describe a new type of agnosia consisting of an impairment in the ability to mentally represent or know what one is feeling. Freud the neurologist coined the term "agnosia" in 1891 before creating ...psychoanalysis in 1895 but the term has not been previously applied to the domain of affective processing. We propose that the concept of "affective agnosia" advances the theory, measurement and treatment of what is now called "alexithymia," meaning "lack of words for emotion." We trace the origin of the alexithymia construct and discuss the strengths and limitations of extant research. We review evidence that the ability to represent and put emotions into words is a developmental achievement that strongly influences one's ability to experience, recognize, understand and use one's own emotional responses. We describe the neural substrates of emotional awareness and affective agnosia and compare and contrast these with related conditions. We then describe how this expansion of the conceptualization and measurement of affective processing deficits has important implications for basic emotion research and clinical practice.
Psychological and physical health are known to improve with emotion processing, which is becoming aware of bodily sensations, accepting them as information that can be translated into emotion ...concepts and expressing them symbolically and linguistically as emotions. Art therapy utilizes the visual arts for processing emotions to facilitate self-expression and communication with the goal of improving psychological wellbeing. The mental health of individuals coping with and recovering from cancer is known to benefit from art therapy. The purpose of this paper is to describe the development of the role of emotion processing in art therapy (REPAT) intervention, which is an 8 week, one and a half hour art therapy intervention created to target emotion processing as a primary mechanism of change, through which art therapy has the potential to reduce symptoms (i.e., depression, pain and fatigue) of women coping with breast cancer. To obtain this goal we used template for intervention description and replication (TIDieR) and GUIDance for the rEporting of intervention Development (GUIDED) guidelines for intervention development description, with the goal of ensuring successful implementation for clinical and research use.
Individuals from different cultures differ in their values, which encompass belief systems that individuals develop based on their culture, and play a pivotal role in shaping their perspectives. ...These values may affect emotion processing (EP): the recognition, interpretation, expression and response to bodily sensations, translated as emotions. These varying values may contribute to distinct emotional experiences, impacting physical and psychological symptoms in breast cancer (BC) survivors.
This cross-sectional study investigated how EP including acceptance, expression (avoidance and approach coping), and awareness, may mediate the relationship between conservation values and symptoms of pain, fatigue, and depression among Arab (
= 62) and Jewish (
= 179) women BC survivors in Israel. Conservation values include tradition, conformity, and security.
Depression and fatigue were negatively correlated with acceptance of emotions, and positively correlated with avoidance and conservation levels. Emotion processing mediated the relationship between conservation and fatigue and depression. Arab women reported higher levels of various values, emotional acceptance, pain, fatigue, and depression symptoms compared to Jewish women. Conservation was higher in Arab women and correlated with both approach and avoidance coping which was not the case in Jewish women. Avoidance coping had a positive relationship with fatigue in the Jewish, but not the Arab women. Similarly, approach coping was negatively related to depression in Jewish, but not in Arab women.
Cultural differences are important for understanding the experience of cancer in individuals from different cultures. Future interventions for more conservative BC survivors should take culture into account.
Objective: Insomnia and fatigue are common, although not inevitable, during breast cancer. This study is one of the first aiming to describe distinct trajectory classes of insomnia and fatigue ...symptoms, and their correlates, from diagnosis through treatment.
Methods: This longitudinal cohort study was conducted at a comprehensive cancer center and community oncology practices. Participants (N = 460) were women diagnosed with any stage of breast cancer in the previous 4 months. Primary outcomes for this ancillary study of the existing cohort were self-reported insomnia and fatigue symptoms assessed repeatedly across 12 months.
Results: Four distinct classes of insomnia symptoms emerged: persistently very high, clinically elevated symptoms (13.7%); high, clinically elevated symptoms (65.9%); stable low (17.2%) or very low (2.6%) symptoms. Five fatigue symptom classes included high, increasing fatigue (9.6%), two recovery classes starting at high (26.3%), or moderate (18.0%) severity at diagnosis, stable low (33.3%) or very low (12.2%) classes. In multivariate analyses, higher depressive symptoms, anxiety, and chronic life stress were associated with being in the very high insomnia class versus the low symptom class. Oncologic factors were not associated with insomnia class membership. Receiving chemotherapy was linked significantly to high and recovery fatigue symptom classes versus the low class. Higher chronic life stress was associated with more persistent fatigue symptoms.
Conclusions: Distinct classes of insomnia and fatigue symptoms were evident; 79.6% of the women had clinically elevated, persistent insomnia symptoms, 53.9% had elevated fatigue. A substantial minority evidenced low symptoms, suggesting targeted or stepped-care approaches to symptom management.
Among individuals coping with cancer, emotional approach coping—expressing and processing emotions following negative events—has been identified as a potentially adaptive form of emotion regulation. ...However, its mental health benefits may depend on social-cognitive factors and on how it is implemented. This study examined loneliness as a determinant of emotion regulation associations with depressive symptoms in women with breast cancer. Loneliness was examined as an implicit social-cognitive phenomenon (i.e., automatic views of oneself as lonely), and emotional expression and processing were examined as both explicit and implicit processes. Approximately 11 months after diagnosis, 390 women completed explicit measures of coping through cancer-related emotional expression and processing; an implicit measure of expression and processing (an essay-writing task submitted to linguistic analysis); and an implicit association test measuring loneliness. Depressive symptoms were assessed 3 months later. Regardless of implicit loneliness, self-reported emotional expression (but not emotional processing) predicted
fewer
depressive symptoms, whereas
implicit
expression of negative emotion during essay-writing predicted
more
symptoms. Only among women high in implicit loneliness, less positive emotional expression and more causal processing during the writing task predicted more depressive symptoms. Results suggest that explicit and implicit breast cancer-related emotion regulation have distinct relations with depressive symptoms, and implicit loneliness moderates effects of implicit emotional approach. Findings support implicit processes as influential mechanisms of emotion regulation and suggest targets for intervention among breast cancer survivors.
Background
Many breast cancer survivors experience fatigue, mood, and sleep disturbances.
Purpose
This study aims to compare a meditative movement practice, Qigong/Tai Chi Easy (QG/TCE) with sham ...Qigong (SQG), testing effects of meditation/breath aspects of QG/TCE on breast cancer survivors’ persistent fatigue and other symptoms.
Methods
This double-blind, randomized controlled trial tested 12 weeks of QG/TCE versus SQG on fatigue, depression, and sleep among 87 postmenopausal, fatigued breast cancer survivors, stages 0–III, age 40–75.
Results
Fatigue decreased significantly in the QG/TCE group compared to control at post-intervention (
p
= 0.005) and 3 months follow-up (
p
= 0.024), but not depression and sleep quality. Improvement occurred over time for both interventions in depression and sleep quality (all
p
< 0.05).
Conclusions
QG/TCE showed significant improvement over time compared to SQG for fatigue, but not depression or sleep. Both QG/TCE and SQG showed improvement for two prevalent symptoms among breast cancer survivors, depression and sleep dysfunction.
Objective
Apply the National Institutes of Health (NIH) Stage Model to design and test an intervention to prevent depression in breast cancer patients at risk for depression.
Methods
We identified ...mindful emotion awareness, along with approach and avoidance strategies for cancer‐related coping and emotion regulation, as targets for a preventive intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Patients' preferences for individual, in‐person, and time‐efficient sessions informed the design. Patients at risk for depression received a 6‐week, 5‐hour intervention with daily exercises. Intervention targets were assessed at baseline, before each session, and 4‐weeks post intervention. Mixed effects analysis of variance (ANOVA) assessed change over the follow‐up period, controlling for age, partnered status, and disease stage.
Results
Fifty‐five percent (40/72) of women screened within 6 months of diagnosis had elevated depression risk. Of these, 24 (60%) signed consent. Sixteen received intervention after five were excluded for current depressive disorder, cognitive impairment, or death. Three dropped out. Ninety‐eight percent attendance and 77% practice days indicated feasibility. Effect sizes (Cohen's d) corrected for regression to the mean (RTM) were 0.82 for cancer‐related acceptance coping, 0.65 for cancer‐related emotional expression, and 0.32 and 0.42 for decreased cancer‐related avoidance coping and depressive symptoms, respectively. Effect sizes for variables lacking data to correct for RTM were 1.0, 0.7, and 0.5 for decreased rumination, experiential avoidance, and fear of depression, respectively, and 1.3, 0.6, and 0.4 for increased cognitive flexibility, distress tolerance, and describing/not judging emotions, respectively.
Conclusions
The feasibility of this intervention and malleability of its targets support its further investigation.
Metaphors are pervasive in cancer discourse. However, little is known about how metaphor use develops over time within the same patient, and how metaphor use and its content relate to the mental ...health of the patient. Here, we analyzed metaphor use in personal essays written by breast cancer patients shortly after the time of diagnosis and nine months later, in relation to their depressive symptoms at both time points. Results show that metaphor use can provide important insight into a patient's current mental state. Specifically, patients who had no change in their depressive symptom levels used metaphors more densely after nine months. In addition, metaphor valence in the later essay was associated with depressive symptoms at study entry and nine months after. Lastly, we observed a shift in metaphor reference pattern for different symptom trajectories, such that those who recovered from initially elevated depressive symptoms used fewer self-referencing metaphors and more cancer-referencing metaphors in their later essay. Our work suggests that metaphor use reflects how a patient is coping with their diagnosis.
This study explored the feasibility and potentials of a naturalistic observation approach to studying dyadic coping in everyday life. Specifically, it examined the natural context and content of the ...spontaneous cancer conversations of couples coping with cancer, and how they relate to patients' and spouses' psychological adjustment. Women with breast cancer (N = 56) and their spouses wore the electronically activated recorder (EAR), an unobtrusive observation method that periodically records snippets of ambient sounds, over one weekend to observe the couples' cancer conversations in their natural context. Both patients and spouses completed self-reported measures of psychological adjustment at baseline and at a 2-month follow-up. Cancer was a topic of approximately 5% of couples' conversations. Cancer conversations occurred more often within the couple than with friends and family, and they were more often informational than emotional or supportive. Consistent with research on the social cognitive processing model (Lepore & Revenson, 2007), spouses' engagement in emotional disclosure and informational conversation with patients predicted better patient adjustment. This first naturalistic observation study of dyadic coping revealed that the EAR method can be implemented with high compliance and relatively low obtrusiveness within the sensitive context of couples coping with cancer, and having a spouse who discussed cancer in an emotional or informational way predicted better patient adjustment. As a complement to in-lab and other momentary assessment methods, a naturalistic observation approach with a method such as the EAR can contribute to a more comprehensive understanding of the role that communication processes play in coping with cancer.
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