Browsing by Author "LoSavio, Stefanie T."
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Item Construct validity of fear of recurrence among breast cancer survivors(University of Delaware, 2015) LoSavio, Stefanie T.Advancements in cancer detection and treatment have improved the life expectancy of today's cancer patients. With patients living longer, many are now facing the challenges of survivorship. One of the most commonly reported problems among cancer survivors is fear of recurrence. Despite a recent proliferation of literature in the area of fear of recurrence, little theoretical and empirical work has been conducted to define and establish the validity of this important construct. To address this gap in the literature, we proposed and tested a cognitive-emotional theory of fear of recurrence. We then evaluated the convergent, discriminant, and concurrent validity of the theory-consistent items. Three hundred early stage breast cancer survivors completed measures of fear of recurrence, cancer-relevant behavioral outcomes (e.g., health care utilization, functional impairment), and other theoretically-related but distinct constructs (e.g., uncertainty intolerance, general health anxiety). We employed sophisticated structural equation modeling techniques to test our theory of fear of recurrence and evaluate its construct validity. Overall, we found support for our hypothesis that fear of recurrence is a unique construct with predictive power. We hope that findings from this study will expand the theoretical basis for fear of recurrence and serve as a foundation for continued research on this important construct.Item Daily cognitive reactivity as a predictor of later depressive symptoms(University of Delaware, 2012) LoSavio, Stefanie T.Using a daily diary methodology, we assessed whether daily cognitive reactivity -- activation of dysfunctional attitudes by negative affect -- predicts later depressive symptoms and, conversely, whether depressive symptoms predict later cognitive reactivity. At two time points, 10 weeks apart, 161 undergraduates completed a measure of depressive symptoms and daily surveys for seven days that assessed daily negative affect, daily dysfunctional attitudes, and daily negative events. Using multilevel modeling, we computed participants’ daily negative affect-dysfunctional attitudes reactivity slopes, which were used as predictors of later depressive symptoms. Our results showed that Time 1 daily cognitive reactivity was a significant, negative predictor of Time 2 depressive symptoms, controlling for Time 1 depressive symptoms, and that Time 1 depressive symptoms were not a significant predictor of Time 2 daily cognitive reactivity. The negative relationship between Time 1 cognitive reactivity and Time 2 depressive symptoms is in contrast to the positive relationship reported in most previous studies. However, our study was unique in that we assessed daily cognitive reactivity occurring naturally in participants’ everyday experiences. Further examination of our data revealed that the Time 1 positive relationship between negative affect and dysfunctional attitudes was moderated by Time 1 depressive symptoms, such that those higher in depressive symptoms demonstrated weaker daily cognitive reactivity. Based on the emotional context insensitivity literature, we then assessed the possibility that daily stressors did not produce a strong negative emotional reaction for participants with higher depressive symptoms. Specifically, we examined participants’ daily affective reactivity -- increases in negative affect in response to negative events -- and found that initial depressive symptoms moderated the positive relationship between negative events and negative affect, with those higher in depressive symptoms demonstrating weaker daily affective reactivity. Overall, we suggest that participants with higher depressive symptoms experienced smaller increases in naturally-occurring negative affect in response to daily stressors, producing flatter slopes for both affective and cognitive reactivity. Our findings highlight the need to integrate the research literatures on daily cognitive reactivity and daily affective reactivity.