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• W2023800697 abstract "In this issue, you will find a paper by Sherman et al., entitled: “The effect of monitoring processing style on post-surgical neuropathic pain in women with breast cancer”. This commentary focuses on the evidence base relevant to the monitoring processing style (monitoring), based on the accumulating body of work on this construct. Monitoring is a temporally stable dispositional tendency to attend to, scan for and amplify threatening health-related cues or information. Most of the research on monitoring has been assessed using the Monitor-Blunter Style Scale (MBSS), a brief self-report instrument with well-established reliability, validity and utility (Miller, 1987). The MBSS has successfully been used to categorize individuals as either high monitors or low monitors (blunters). The monitoring construct is theoretically derived from the Cognitive–Social Health Information Processing (C-SHIP) model (Roussi and Miller, 2014), which delineates five key cognitive-affective variables that mediate the response to health threats: (1) health-relevant knowledge and perceptions regarding one's personal health risks and vulnerabilities; (2) health-relevant beliefs and expectancies about being able to obtain effective care, as well as self-efficacy expectancies (e.g., degree of confidence in one's ability to cope with a health problem or adhere to recommendations); (3) health-relevant values and goals (e.g., pros and cons of available medical regimens); (4) health-relevant affects and emotions activated in health information processing (e.g., level of anxiety and concerns about a medical result or procedure); and (5) health-relevant self-regulatory competences and skills for coping by generating and maintaining goal-oriented, health-protective behaviours (e.g., for decision making, adherence, managing health-related distress and for achieving effective communication and support). These variables are common denominators in virtually all current cognitive–social models of health behaviour. Based on an extensive network of findings, high monitors generally display a signature cognitive-affective profile when facing health threats. Related to encodings, and expectancies, they know more about their health problem and are more likely to overestimate their personal health risks. They also have more negative beliefs and expectations regarding the health threat, and are more likely to exaggerate its severity and seriousness. In addition, high monitors place greater value on the pros of adhering to their medical care and on acquiring information about their health to help them problem-solve and reduce uncertainty, but are less satisfied with the information they receive from health care providers. At the affective level, high monitors experience more negative emotional responses to health threats notably greater worry, concerns and distress, and are more in need of emotional support, particularly when the threat is high. At the self-regulatory level, when the health threat is more controllable and less severe, e.g., as when undertaking preventive measures for disease via routine screening, high monitors tend to demonstrate high adherence and effective coping. However, when facing more difficult-to-control and severe health threats, e.g., feedback of abnormal results or a diagnosis of cancer, high monitors tend to experience affects such as ‘intrusive ideation’, i.e., intrusive and repetitive thinking about the threat, and ‘avoidant ideation’, i.e. effortfully avoiding thinking about the threat, and consequent denial and disengagement (Miller, 1995). Thus, the high monitoring repertoire entails both effective and ineffective coping, the former when the health threat is more controllable and routine, and the latter when it is more uncontrollable, severe and uncertain. The Sherman et al. article adds to this literature, by showing that monitoring is associated not only with cognitive-affective and behavioural factors but also with post-surgical pain levels among women who have undergone breast cancer surgery. These results are significant since they suggest that sustained attention to health threats involves not only increased subjective stress among high monitors but also higher somatic symptom monitoring and actual somatic symptoms over time. These findings parallel previous results showing that high monitors show greater physiological arousal in the face of health threats, as well as greater symptomatology (e.g., nausea and vomiting) in response to cancer treatments. Taken together, this body of research indicates that it is important to consider signature personality profiles such as monitoring when designing interventions at the biobehavioural level, including psychoeducational, counselling, psychotherapeutic, symptom management and support interventions in the health context. In response to routine or short-term diagnostic and surgical procedures, interventions that provide detailed procedural and sensory preparatory information appear to be efficacious for high monitors, since information decreases uncertainty, risk perceptions and worry. However, when facing more long-term, severe and recurrent health threats, such as in the context of diagnosis, treatment or post-treatment phase, support and coping skills to enhance psychological and medical outcomes may be beneficial, in conjunction with information and reassurance about the consequences of the procedure. The agenda for future research is to improve patient-centred outcomes and quality of care by assessing and addressing monitoring processing styles in a preventive fashion so that psychosocial outcomes, pain management and related symptom monitoring are enhanced, whether through use of traditional, digital or web-based communication technologies. The research was supported from the National Cancer Institute grant R01 CA158019 and Fox Chase Cancer Center Behavioral Research Core Facility grant NIH P30 CA06927. I thank Mary Anne Ryan and John Scarpato for their technical assistance." @default.
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• W2023800697 date "2015-03-24" @default.
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• W2023800697 title "Monitoring processing style: To see or not to see" @default.
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• W2023800697 doi "https://doi.org/10.1002/ejp.664" @default.
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