Clinical variables and severe acute pain were risk factors for chronic pain following breast cancer surgery, but psychosocial distress was not, which provides a basis for hypothesizing that aggressive management of acute postoperative pain may reduce chronic pain.

Much evidence suggests that marital discord is related to depressive symptoms in married couples. In the present research, potential sex-related differences in the prospective effect of marital discord on depression were explored. Further, extending previous work, cross-spouse effects (i.e., the associations between one spouse's marital discord and his or her partner's later levels of depressive symptoms) were examined. Spouses from randomly sampled married couples (N = 166) with adolescent children provided reports of their marital quality and depressive symptoms at baseline and one year later. Structural equation modeling analyses were conducted. Results revealed that Time 1 marital quality was associated with Time 2 depressive symptoms, the magnitude of this effect was similar for both husbands and wives, and spouses' own marital quality at Time 1 predicted their partners' Time 2 depressive symptoms net of other predictors in the model. Implications for practice, policy, and future research are discussed. KEY WORDS: depression • longitudinal study • marriage Journal of Social and Personal Relationships

Although more severe acute postoperative pain increases the risk of chronic pain following breast cancer surgery, few studies have examined the characteristics of patients who develop greater acute pain. To identify risk factors for acute pain and its persistence one month following breast cancer surgery, a sample of 114 women scheduled for breast cancer surgery was assessed preoperatively for demographic, clinical, and emotional functioning variables that were hypothesized to be associated with acute pain severity. Clinically meaningful postoperative pain was assessed at follow-up interviews 2, 10, and 30 days after surgery. In univariate analyses, the risk of clinically meaningful acute pain was increased among women who were younger, unmarried, had more invasive surgeries, and had greater preoperative emotional distress. In multiple logistic regression analyses, greater preoperative anxiety was the only variable that made an independent contribution to predicting clinically meaningful acute pain at 2 days after surgery whereas younger age, being unmarried, and preoperative anxiety each made an independent contribution to predicting clinically meaningful acute pain that persisted from 2 to 30 days after surgery. These results increase understanding of neurobiologic mechanisms and psychosocial processes that contribute to the development of acute pain following breast cancer surgery and have implications for the development of interventions to prevent it.

The present meta-analysis evaluated the effectiveness of bystander education programs for preventing sexual assault in college communities. Undergraduates trained in bystander education for sexual assault were expected to report more favorable attitudes, behavioral proclivities, and actual behaviors relative to untrained controls. Data from 12 studies of college students (N = 2,926) were used to calculate 32 effect sizes. Results suggested moderate effects of bystander education on both bystander efficacy and intentions to help others at risk. Smaller but significant effects were observed regarding self-reported bystander helping behaviors, (lower) rape-supportive attitudes, and (lower) rape proclivity, but not perpetration. These results provide initial support for the effectiveness of in-person bystander education training. Nonetheless, future longitudinal research evaluating behavioral outcomes and sexual assault incidence is needed.

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Although the effects of postherpetic neuralgia on physical and emotional functioning have been examined in a number of studies, the impact of acute pain in herpes zoster ("shingles") on health-related quality of life has been neglected. We describe the characteristics of herpes zoster pain and examine its relationship to physical, role, social, and emotional functioning in 110 patients with herpes zoster. When we controlled for relevant covariates, we found that greater pain burden, as assessed by the product of pain intensity and duration, was associated with poorer physical functioning, increased emotional distress, and decreased role and social functioning. The results demonstrate that herpes zoster pain has broad effects on the daily lives of patients and on their emotional health. The increasing incidence of herpes zoster that can be anticipated as the population ages requires that clinical trials that examine interventions to prevent or treat herpes zoster pain be given a high priority.

The results suggest that study characteristics may contribute to the outcomes of clinical trials of treatments for neuropathic pain and provide an impetus for investigating strategies for decreasing placebo response rates and thereby possibly increasing the likelihood of positive outcomes in trials of efficacious treatments.

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