One of the goals of the NIH Toolbox for Assessment of Neurological and Behavioral Function was to identify or develop brief measures of emotion for use in prospective epidemiologic and clinical research. Emotional health has significant links to physical health and exerts a powerful effect on perceptions of life quality. Based on an extensive literature review and expert input, the Emotion team identified 4 central subdomains: Negative Affect, Psychological Well-Being, Stress and Self-Efficacy, and Social Relationships. A subsequent psychometric review identified several existing self-report and proxy measures of these subdomains with measurement characteristics that met the NIH Toolbox criteria. In cases where adequate measures did not exist, robust item banks were developed to assess concepts of interest. A population-weighted sample was recruited by an online survey panel to provide initial item calibration and measure validation data. Participants aged 8 to 85 years completed self-report measures whereas parents/guardians responded for children aged 3 to 12 years. Data were analyzed using a combination of classic test theory and item response theory methods, yielding efficient measures of emotional health concepts. An overview of the development of the NIH Toolbox Emotion battery is presented along with preliminary results. Norming activities led to further refinement of the battery, thus enhancing the robustness of emotional health measurement for researchers using the NIH Toolbox.

The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12) is a 12-item questionnaire that measures spiritual well-being in people with cancer and other chronic illnesses. Cancer patients, psychotherapists, and religious/spiritual experts provided input on the development of the items. It was validated with a large, ethnically diverse sample. It has been successfully used to assess spiritual well-being across a wide range of religious traditions, including those who identify themselves as “spiritual yet not religious.” Part of the larger FACIT measurement system that assesses multidimensional health related quality of life (HRQOL), the FACIT-Sp-12 has been translated and linguistically validated in 15 languages and has been used in dozens of studies examining the relationships among spiritual well-being, health, and adjustment to illness.

Religion and spirituality (R/S) are patient‐centered factors and often are resources for managing the emotional sequelae of the cancer experience. Studies investigating the correlation between R/S (eg, beliefs, experiences, coping) and mental health (eg, depression, anxiety, well being) in cancer have used very heterogeneous measures and have produced correspondingly inconsistent results. A meaningful synthesis of these findings has been lacking; thus, the objective of this review was to conduct a meta‐analysis of the research on R/S and mental health. Four electronic databases were systematically reviewed, and 2073 abstracts met initial selection criteria. Reviewer pairs applied standardized coding schemes to extract indices of the correlation between R/S and mental health. In total, 617 effect sizes from 148 eligible studies were synthesized using meta‐analytic generalized estimating equations, and subgroup analyses were performed to examine moderators of effects. The estimated mean correlation (Fisher z) was 0.19 (95% confidence interval [CI], 0.16‐0.23), which varied as a function of R/S dimensions: affective R/S (z = 0.38; 95% CI, 0.33‐0.43), behavioral R/S (z = 0.03; 95% CI, −0.02‐0.08), cognitive R/S (z = 0.10; 95% CI, 0.06‐0.14), and ‘other’ R/S (z = 0.08; 95% CI, 0.03‐0.13). Aggregate, study‐level demographic and clinical factors were not predictive of the relation between R/S and mental health. There was little indication of publication or reporting biases. The correlation between R/S and mental health generally was positive. The strength of that correlation was modest and varied as a function of the R/S dimensions and mental health domains assessed. The identification of optimal R/S measures and more sophisticated methodological approaches are needed to advance research. Cancer 2015;121:3769–3778. © 2015 American Cancer Society.

BACKGROUND: Young adults (YAs; ages 18‐39 years) with cancer face interrupted developmental milestones and increased stressors that can adversely influence psychosocial adjustment. Transitioning from active treatment to posttreatment survivorship can be particularly challenging. The purpose of this study is to describe the health‐related quality of life (HRQL) and psychological adaptation of YAs after treatment, relative to young adults without cancer.METHODS: Three cohorts of YAs of mixed cancer diagnoses (N = 120, 0‐12 months after treatment; N = 102, 13‐24 months after treatment; and N = 113, 25‐60 months after treatment; combined M = 31.8 years old, combined sex = 68% women) and an age‐, education‐, sex‐, and partner status–matched group of healthy control participants (HCs; N = 335) were recruited via an online research panel. All participants completed measures assessing demographic and clinical characteristics, HRQL (physical, emotional, social, and spiritual), and psychological adaptation (anxiety, depression, positive affect, posttraumatic growth). Measure content was slightly modified for applicability to HCs without a cancer history.RESULTS: Multivariate analysis of covariance found a significant main effect for group (YAs versus HCs) and a significant group‐by‐cohort interaction. YAs reported poorer physical (P = .005, d = .22) and emotional well‐being (P = .011, d = .20) but better social well‐being (P < .001, d = .49). YAs reported comparatively stable scores (P = .74) for posttraumatic growth compared to HCs, who reported greater posttraumatic growth across cohorts (P = .01, d = 16).CONCLUSIONS: Findings underscore the negative and positive sequelae for YAs and highlight the need for comprehensive assessment among YA survivors of cancer. A matched, HC group allows the HRQL and psychological adaptation of YAs to be placed in context, enabling a more precise determination of the impact of cancer on YAs. Cancer 2014;120:2247–2254. © 2014 American Cancer Society.