Thomas J. Nehmy

Bio: Thomas J. Nehmy is an academic researcher from Flinders University. The author has contributed to research in topics: Intrusive thought & Thought suppression. The author has an hindex of 9, co-authored 9 publications receiving 341 citations.

Predicting worries about health after breast cancer surgery

Abstract: Given the widespread worries about future health in women with breast cancer, it is important to understand the predictors of such fear so that possible avenues for intervention can be formulated. In this longitudinal study of 44 women who had undergone breast cancer surgery, we look at demographic variables, cancer and treatment related symptoms, and denial coping measured post-surgery and their ability to predict future health fears at 6-weeks and 12-weeks post-surgery. At both follow-up periods, around 1 in 5 women had strong worries about their future health, and post-surgery future health fears significantly predicted future health fears. In a hierarchical multiple regression, controlling for post-surgery health fears, future health fears at both follow-up periods were predicted only by denial coping. Cross-lag analyses suggested that these relationships were causal. Findings suggest that denial coping is a powerful predictor of future health fears, with this relationship growing stronger over time. Future research should investigate which interventions can decrease denial, and whether this then decreases health fears in the aftermath of breast cancer surgery. Copyright © 2004 John Wiley & Sons, Ltd.

Rates of post-traumatic stress disorder in trauma-exposed children and adolescents:

Abstract: Background It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma. Aims To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate. Method A systematic literature search identified 72 peer-reviewed articles on 43 independent samples (n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance. Results The overall rate of PTSD was 15.9% (95% CI 11.5–21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7–14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8–49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment. Conclusions Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.

Episodic Memory, Perceptual Memory, and Their Interaction: Foundations for a Theory of Posttraumatic Stress Disorder

Abstract: A number of autobiographical memory theories and clinical theories of posttraumatic stress disorder (PTSD) make claims that are different from standard views of memory and have been the subject of controversy. These claims include the existence of a long-term perceptual memory system supporting conscious experience separate to episodic memory; greater involvement of perceptual memory in the response to emotion-laden and personally meaningful events; increased perceptual memory intrusions accompanied by impaired episodic memory for the traumatic event among PTSD patients; and a lack of association, or inverse association, between indices of voluntary recall and involuntary images relating to the same traumatic materials. In this article I review current research on perceptual memory, which supports the presence of long-term representations that are selective or incomplete reflections of sensory input. The functional independence of perceptual and episodic memory is illustrated by research on verbal overshadowing but is most clearly exemplified by the strong evidence in favor of enhanced perceptual memory and impaired episodic memory in PTSD. Theoretical predictions concerning the relation between perceptual priming and the development of intrusive images, the effect of verbal versus visuospatial secondary tasks on intrusive trauma images, and the independence of voluntary and involuntary memory for the same materials have garnered widespread support. Reasons for the continuing controversy over traumatic memory are discussed, and some implications of the review for general theories of recall and recognition, clinical theories of PTSD, and "special mechanism" views of memory are set out.

Factors reported to influence fear of recurrence in cancer patients: a systematic review.

Abstract: Fear of cancer recurrence (FCR) is a significant psychological problem for cancer survivors. Some survivors experience FCR, which is both persistent and highly distressing. The aim of this systematic review was to identify the key factors associated with fear of recurrence among cancer patients. Methods A comprehensive literature search using keywords was performed with three databases, followed by an organic search to identify additional relevant articles. Included studies had a quantitative methodology presenting empirical findings focussed on adult cancer patients. A methodological quality assessment was performed for each study, and the strength of evidence was defined by the consistency of results. Results Forty-three studies met the inclusion criteria and are presented in this review. The most consistent predictor of elevated FCR was younger age. There was strong evidence for an association between physical symptoms and fear of cancer recurrence. Additional factors moderately associated with increased FCR included treatment type, low optimism, family stressors and fewer significant others. Inconsistent evidence was found for socio-demographic factors. Conclusions Fear of cancer recurrence is a complex issue influenced by a multitude of factors, including demographic, clinical and psychological factors. However, some studies have reported contradictory evidence, and FCR has been measured using a range of scales, which can hamper comparison across studies. Further research is needed to clarify inconsistencies in the current published research.