Psychological Distress and Symptom Burden: Vulnerabilities in Chronic Lymphocytic Leukemia Patients
Bibliographic record
Abstract
Chronic lymphocytic leukemia is the most common adult leukemia in the U.S. (American Cancer Society, 2010).CLL is chronic and incurable.Most patients with early-stage disease do not receive treatment, but instead undergo active surveillance for disease progression.Cancer is associated with distress (Zabora et al., 2001), the risk of which is heightened in the presence of vulnerability factors (Harrison & Maguire, 1994).Distress is also associated with reporting of physical symptoms (Carr et al., 2002).This cross-sectional study examined the moderating role of vulnerability factors in the relationship between distress and physical symptom burden in a sample of untreated CLL patients (N=112).Participants were Caucasian (100%), had a mean age of 61 (range: 37-76), with the majority (62.5%) having stage 0 disease (I: 32.1%; II: 4.5%).Gender distribution was relatively even (55% male).Moderators of interest were psychiatric history (diagnosis, pharmacotherapy, psychotherapy); lack of partner status and low relationship satisfaction; low social support; and low socioeconomic status.Interaction effects were tested using multiple linear regression.Physical symptom burden and distress were bidirectionally predictive.Significant moderators were: pharmacotherapy, psychotherapy, and low social support.Post hoc analyses of social support showed that low appraisal (i.e.availability of someone with whom to discuss problems) and low belonging (i.e.availability of companionship) support were also significant moderators.These findings have implications for identifying active surveillance patients at risk for worse physical and psychological adjustment while coping with CLL.One of my earliest mentors was Professor John R.Z.Abela (1971-2010), with whom I worked during my years at McGill University.Dr. Abela, thank you for your mentorship, insight, humor, and encouragement.The impact of your absence is truly felt.Thank you to current and past members of the Stress and Immunity Cancer Projects lab for the camaraderie
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".