Guy H. Montgomery | The Mount Sinai School of Medicine (original) (raw)

Papers by Guy H. Montgomery

PAIN Reports

Introduction: Women who undergo breast cancer surgery risk suffering from postsurgical pain long ... more Introduction: Women who undergo breast cancer surgery risk suffering from postsurgical pain long after their surgery. Still, research on postsurgical pain in the subacute phase has been neglected. Objective: This study aims to investigate the incidence, intensity, unpleasantness, and presurgical predictors of acute and subacute postsurgical pain after breast cancer surgery. Methods: The study used an observational design through secondary analyses of the control group in a randomized controlled trial. Data from 102 women undergoing breast cancer surgery were included. Levels of acute and subacute pain intensity and unpleasantness were measured using 100 mm Visual Analogue Scales on the day of surgery and 4 weeks postsurgery. Linear regression analyses were performed to identify presurgical biopsychosocial predictors of acute and subacute postsurgical pain. Results: Average levels of postsurgical pain intensity and unpleasantness were as follows: 22.7 mm for acute pain intensity, 19....

Addictive Behaviors, 2022

OBJECTIVE Among the major impediments to successful smoking cessation are strong cravings, especi... more OBJECTIVE Among the major impediments to successful smoking cessation are strong cravings, especially during times of heightened stress. Affective responses to stress (e.g., acute anxious and depressed mood) may serve as important mediators of cigarette cravings that are amenable to intervention. Experimental models have been developed to reliably induce cravings during stress under laboratory conditions, permitting a closer examination of possible changes in affect that may be driving cigarette cravings. A key limitation of the extant research is its reliance on samples of predominantly White males who smoke. Although several recent studies suggest possible gender- and race/ethnicity-based differences in affective responses to acute stress, no studies have explored how such differences may contribute to cigarette cravings. METHOD To address this gap, we conducted an experimental study in which a diverse sample of healthy volunteer female (n = 163) and male (n = 139) nicotine-dependent individuals who smoked were exposed to a stressor (guided imagery of painful dental work). We assessed negative affect and cigarette craving immediately before and after the imaginal dental stressor. RESULTS Path analyses revealed that the acute stressor induced increases in negative affect, which, in turn, increased cigarette craving (significant direct and indirect effects, p's < 0.05; R2indirect = 0.5). Interestingly, effects were more pronounced in women and in non-White individuals who smoked. CONCLUSIONS Results highlight the important roles of stress and affect in craving, and the need to consider gender and race/ethnicity when developing interventions to manage stress-induced cigarette cravings among individuals attempting to quit.

Journal of Evidence-Based Psychotherapies, 2013

AbstractThe present exploratory study investigated the interrelations among irrational cognitive ... more AbstractThe present exploratory study investigated the interrelations among irrational cognitive processes, cognitive contents and specific emotions in breast cancer patients undergoing radiotherapy. The data were collected during a randomized clinical trial investigating a cognitive behavioral therapy intervention for breast cancer women undergoing radiotherapy. Intervention group participants had to complete 2 worksheets (in which they described their thoughts and emotions) per every week of intervention. The content of the worksheets was coded into 3 categories: irrational cognitive processes, cognitive contents and emotions. Coding was based on Rational-Emotive Behavior Theory. The irrational cognitive processes most frequently exhibited by these patients were low frustration tolerance (82.3% of the patients), demandingness (79.4%), and catastrophizing (76.5%). The cognitive contents most frequently exhibited were comfort (88.2% of the patients) and fairness (67.6%). The most co...

Rational and Irrational Beliefs, 2009

This chapter proposes a theoretical model that could potentially increase our understanding of th... more This chapter proposes a theoretical model that could potentially increase our understanding of the effects of irrational beliefs on health outcomes. It has been written that REBT “is perhaps the only therapeutic system that directly tackles our confrontation with reality.” Also as humans cannot help but be all too aware, physical suffering is an inextricable part of reality. REBT arms us in our struggle with this aspect of reality by providing us with two weapons: a willingness to accept reality, combined with an unwillingness to accept our irrational interpretations of that reality.

Preventive Medicine, 2000

may need to be balanced by educational efforts con-Background. The threat that breast cancer pose... more may need to be balanced by educational efforts con-Background. The threat that breast cancer poses to cerning women's risk of other diseases, particularly American women, particularly to women with family cardiovascular disease. ᭧ 2000 American Health Foundation and histories of the disease, has received widespread atten-Academic Press tion in both medical and popular literatures. While this Key Words: family history; breast cancer; heart disemphasis may have laudable consequences on breast ease; perceived risk. cancer screening, it may also have a negative consequence, obscuring women's recognition of their risks for other health threats, such as heart disease. This INTRODUCTION study examined the possibility that women with family histories of breast cancer may be particularly suscepti-Breast cancer is the most frequently diagnosed canble to overestimating their risks of breast cancer while cer among women in the United States [1]. Current minimizing their risks of cardiovascular disease. estimates suggest that one of every eight women in Methods. Healthy women with (n ‫؍‬ 73) and without the United States (12.5%) will develop breast cancer at (n ‫؍‬ 104) family histories of breast cancer (64% African some point during her lifetime. Having a first-degree American, 26% Caucasian, 10% other ethnicities, mean relative with breast cancer places a woman at an even age 41.7 years) were recruited from medical centers in higher lifetime risk for developing the disease [2]. In-New York City, and completed questionnaires concerndeed, research has demonstrated that these women are ing their family histories and perceptions of risk. aware of their increased risk. A number of studies (e.g., Results. Consistent with the study hypothesis, [3,4]) have repeatedly found that perceptions of breast women with family histories of breast cancer had sigcancer risk among women with family histories of nificantly higher perceived lifetime risk of breast canbreast cancer are significantly higher than among cer (P Ͻ 0.0002) but lower perceived lifetime risk of women without family histories of breast cancer and heart disease (P Ͻ 0.002) than women without family far higher than objective estimates. Indeed, a number of histories. Additionally, women with family histories of studies (e.g., [5-7]) have demonstrated that American breast cancer had lower perceived colon cancer risk women in general markedly overestimate their risk of (P Ͻ 0.02), suggesting that women with family histories of breast cancer may be underestimating their risks developing the disease, with many women perceiving for a variety of diseases. themselves to be at extremely high lifetime risk. For Conclusion. The emphasis on breast cancer risk, esexample, Helzlsouer et al. [6] found that even employees pecially for women with family histories of the disease, in an oncology center, whom one might expect to be more knowledgeable than lay people, perceived themselves to be at greater than 40% lifetime risk. Evans et al. [7] 1 This research was sponsored in part by grants from the National found that while some women with family histories of Cancer Institute (R01 CA72457; Bovbjerg) and the Department of breast cancer underestimated their risk, most overesti-Defense (DAMD 17-99-1-9305; Erblich). We are required to indicate mated their risk and many overestimated their risk that the content of the information contained in this report does not necessarily reflect the position or policy of the United States by more than 50%. Several recent studies (e.g., [8,9]), Government. noting the large scale dissemination of breast cancer-2 To whom reprint requests should be addressed at Ruttenberg

The Diabetes Educator, 2011

Purpose Diabetes is increasingly prevalent, and nonadherence with diabetes treatment regimens is ... more Purpose Diabetes is increasingly prevalent, and nonadherence with diabetes treatment regimens is associated with physical and social costs. Psychological predictors of adherence have been investigated in the literature, including cognitive factors. The present meta-analysis was conducted to investigate the association between beliefs related to diabetes and adherence to diabetes regimens. Methods Studies that measured both (a) beliefs, perceptions, or cognitions about diabetes and (b) the relationship between such cognitive factors and blood glucose levels or other adherence behaviors were included. This research focused on adults with any type of diabetes, reaching a final sample of 48 studies. The effect size r was calculated for all types of beliefs and outcomes. Results The types of beliefs most strongly associated with adherence were self-efficacy, perceiving a positive relationship with physician, and beliefs about the personal consequences of adherence. A few limitations of t...

Psychological Science, 1996

Identical experimental pain stimuli were applied to the right and left index fingers of 56 univer... more Identical experimental pain stimuli were applied to the right and left index fingers of 56 university students, following the application of a placebo in the guise of a topical anesthetic to one of the fingers The pain stimuli were administered simultaneously to treated and untreated fingers for half of the subjects and sequentially for the others Significant and equivalent reductions in pain were reported in both conditions as a function of placebo administration These data indicate that reductions of experimental pain produced by placebos presented in the guise of local anesthetics are not mediated by such global mechanisms as anxiety reduction or the release of endogenous opioids

Preventive Medicine, 2002

Background. While women are far more likely to develop and die from cardiovascular disease (CVD) ... more Background. While women are far more likely to develop and die from cardiovascular disease (CVD) than breast cancer, research has shown that they markedly overestimate their personal risks of breast cancer and underestimate their CVD risks. The source of this disparity is not yet known, although increased media attention to breast cancer relative to CVD has been suggested to play a role. The purpose of the present study was to provide a first critical test of this possibility. Two hypotheses were tested: (a) the number of breast cancer articles would be greater than the number of CVD articles; and (b) this disparity in coverage would increase over the years. Methods. A web-based search engine was used to quantify all breast cancer and cardiovascular disease articles (keyword search) in 73 popular magazines on a annual basis for a 10-year interval (1990-1999). Results. Consistent with study hypotheses, breast cancer articles outnumbered CVD articles, and this disparity widened over the years (P < 0.0001). This disparity was not limited to specific magazine categories (e.g., women's interest). Conclusions. Over-representation of breast cancer visa -vis CVD is pervasive in popular magazines. Future research should investigate how such disparities in the media may influence risk perceptions, adoption of preventive health behaviors, and compliance with screening guidelines.

The Journal of Pain, 2008

ABSTRACT Over 30% of HIV patients suffer from symptomatic HIV-associated distal sensory polyneuro... more ABSTRACT Over 30% of HIV patients suffer from symptomatic HIV-associated distal sensory polyneuropathy (HIV- DSP). The pain symptoms adversely affect patients' quality of life and are often severe enough to diminish their capacity for independent self-care. HIV-DSP is not reversible. Current treatments are typically pharmacological palliation. None of these treatments are uniformly or consistently effective, and they sometimes have unacceptable side-effects. A behavioral intervention such as hypnosis, either alone or in combination with medication, could potentially decrease pill burden and provide another useful treatment. To determine the effectiveness of hypnosis in treating painful HIV-DSP, 38 patients received 3 weekly training sessions in self-hypnosis. The diagnosis of HIV-DSP was established by neurological examination. Patients were followed for pain and its sequelae for 7 weeks prior to the intervention, and for 7 weeks post-intervention. Patients remained on the same standard of care regimen for the entire 17 weeks of the protocol. The primary outcome measure was the Short Form McGill Pain Scale Total Pain score. Mean total pain scores were reduced from 17.2 to 12.5 [F (1, 36) = 17.06, p

Journal of Clinical Psychology, 2005

In the current literature, distress is typically described according to a unitary model: High lev... more In the current literature, distress is typically described according to a unitary model: High levels of distress are conceptualized as a high level of negative affect while low levels of distress are typically conceptualized as a low level of negative affect. On the other hand, Albert Ellis (1994) and some of his rational-emotive and cognitive-behavioral professional colleagues have more recently described distress as a binary construct composed of two different components: functional negative feelings (e.g., sad) and dysfunctional negative feelings (e.g., worthless). In two studies using 55 U.S. breast-cancer patients and 45 Romanian breast-cancer patients, respectively, we compared hypotheses derived from unitary and binary

Journal of Clinical Psychology, 2004

Research in health psychology and behavioral medicine has increased exponentially over the past t... more Research in health psychology and behavioral medicine has increased exponentially over the past three decades. Prevention and control efforts across a variety of diseases have recognized that individual difference factors, belief systems, attitudes, behaviors, and environments can affect an individual's health. This work continues, as there has been no abatement in the rate at which aversive, chronic, and life-threatening diseases continue to affect millions of Americans each year. The purpose of this review is to discuss the influence of cognitive factors on health psychology and behavioral medicine using the cancer literature as an example. The main discussion focuses on the impact of cognitive constructs on behavioral medicine and health psychology in cancer, which appears to be widespread. The article concludes with some implications for future research in the area.

Journal of Behavioral Medicine, 2005

Fatigue is the most common side effect of chemotherapy for cancer. Not yet explored is the possib... more Fatigue is the most common side effect of chemotherapy for cancer. Not yet explored is the possibility that patients may develop conditioned fatigue responses to clinic cues as a result of the repeated pairing of the clinic environment (conditioned stimulus) with infusions of chemotherapy (unconditioned stimulus) that cause fatigue (unconditioned response). As a first critical test of this possibility, breast cancer patients (N = 82) were studied across their first four cycles of chemotherapy. Consistent with conditioning: (1) fatigue levels in the clinic environment significantly increased with repeated pairings of the clinic environment and chemotherapy administration; (2) fatigue responses in the clinic environment prior to the fourth infusion (CR) were predicted by patients' previous experiences of post-infusion fatigue (UR) above and beyond effects of concurrent emotional distress. These results provide the first evidence in the literature that fatigue can be conditioned. Additional research is warranted to determine the clinical importance of this source of fatigue in chemotherapy patients.

International Journal of Clinical and Experimental Hypnosis, 1998

Suggestions for arm levitation and for visual, auditory, tactile, and taste hallucinations were a... more Suggestions for arm levitation and for visual, auditory, tactile, and taste hallucinations were administered twice via audiotape to a group of high suggestible students and low suggestible simulators. During one of the administrations, participants were led to believe they were alone, but their behavior was surreptitiously recorded on videotape and observed on a video monitor. During the other administration, they were observed openly by an experimenter who had not been informed about group assignment. When unaware that they were being observed, simulators were significantly less responsive to suggestion and engaged in substantially more role-inappropriate behavior. In contrast, the responsiveness of nonsimulating students was not affected by the presence of an experimenter, and they exhibited little role-inappropriate behavior even when alone. These data indicate that the responses of suggestible individuals reflect internally generated changes in experience and are not due to simple intentional compliance (i.e., faking).

British Journal of Health Psychology, 2000

Objectives. To examine the relations between expectations of post‐treatment nausea (PTN) and expe... more Objectives. To examine the relations between expectations of post‐treatment nausea (PTN) and experience of post‐treatment nausea beginning at the first infusion and continuing across a series of subsequent infusions in order to assess the influence of patients' expectations on a non‐volitional outcome in a clinical setting. Design. The study utilized a prospective, longitudinal design to capture the development of relations between expectations and experiences of post‐treatment nausea.Methods. Fifty‐two women with breast cancer scheduled to receive standard outpatient adjuvant chemotherapy were studied. Study questionnaires included measures of chemotherapy‐related side effects, patient expectations, emotional distress and mood disturbance.Results. Significant relations between expectations and incidence of post‐treatment nausea at Infusions 2‐7 were found (p < .05). To explore the possibility that expectations were simply based on patients' most recent experience of post...

Annals of Behavioral Medicine, 2004

Background: Despite literature finding support for the social cognitive processing model, which s... more Background: Despite literature finding support for the social cognitive processing model, which suggests that social constraints are related to distress, few studies have examined possible mediators of this effect; none have examined this relation among women with family histories of breast cancer (FH+). Purpose: This study was designed to examine possible effects of social constraints on psychological distress among FH+ women. Methods: Sixty FH+ women (M age = 39.2 years) completed self-report measures of social constraints, avoidance, and general and cancer-specific distress. Results: Multiple regression analyses revealed that social constraints were significantly related to both cancer-specific and general distress and that avoidance partially mediated the relation between social constraints and both types of distress. Conclusions: Theoretical and clinical implications of these findings are discussed.

American Journal of Clinical Hypnosis, 2005

The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.

American Journal of Clinical Hypnosis, 1996

Some clinicians maintain that responses to the Chevreul pendulum illusion are facilitated by rest... more Some clinicians maintain that responses to the Chevreul pendulum illusion are facilitated by resting one's elbow on a table. Others claim the reverse. We compared these two methods in a counterbalanced crossover design by having 32 university students perform the Chevreul pendulum illusion with their elbows supported on a table and with their elbows unsupported. Although there was no main effect for method (elbow supported versus elbow unsupported), subjects who rested their elbows on a table on the first trial were more successful in responding on both trials. This suggests that supporting the elbow does facilitate responding, but only on the initial trial. Performance on subsequent trials is determined by degree of success on the first trial. Similar data from a previous study comparing different hypnotic inductions suggests that this phenomenon is generalizable beyond the Chevreul pendulum illusion and supports the hypothesis that the test-retest reliability of suggestibility scales may be due to a stabilization of response expectancy by a person's first experience of imaginative suggestions.