{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T18:20:46Z","timestamp":1774894846972,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["R01NR016838"],"award-info":[{"award-number":["R01NR016838"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["T32 CA00946"],"award-info":[{"award-number":["T32 CA00946"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The life\u2010threatening nature of cancer can precipitate posttraumatic stress symptoms (PTSS) in family caregivers. PTSS can lead to unhealthy coping and maladaptive health behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We explored the extent to which PTSS are associated with health behaviors of caregivers and the moderating role of gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Spousal caregivers (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0144) of patients who were newly diagnosed with colorectal cancer were enrolled. The sample was comprised of mostly Hispanic, middle\u2010aged, and female caregivers. Four types of cancer\u2010related PTSS (intrusions, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) and health behaviors (substance use and improper healthcare utilization) were self\u2010reported. Study hypotheses were tested using logistic and negative binomial regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Caregivers overall reported higher alcohol use than CDC recommendations. Male caregivers reported greater alcohol use and more improper healthcare utilization compared with their female counterparts (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.03). Among female caregivers only, greater avoidance was associated with less improper healthcare utilization, and greater negative alterations in cognitions and mood was associated with more improper healthcare utilization (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2264\u00a00.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings that male caregivers are more vulnerable to alcohol use and improper healthcare utilization highlight the need for healthy lifestyle coping interventions tailored specifically to male caregivers. In contrast, female caregivers who exhibit elevated negative alterations in cognitions and mood are at greater risk for improper healthcare utilization than male counterparts. Findings suggest that interventions targeting cancer\u2010related PTSS may help improve engagement of proper healthcare utilization and reduce the risk for premature morbidity among female caregivers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70412","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:15:13Z","timestamp":1773033313000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Cancer\u2010Related Posttraumatic Stress Symptoms and Gender With Health Behaviors Among Caregivers of Adult Patients With Colorectal Cancer"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5321-5270","authenticated-orcid":false,"given":"Hannah\u2010Rose","family":"Mitchell","sequence":"first","affiliation":[{"name":"Ferkauf Graduate School of Psychology Yeshiva University  Bronx New York USA"},{"name":"Department of Epidemiology and Population Health Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4244-9124","authenticated-orcid":false,"given":"Thomas C.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Miami  Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Quintana","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Miami  Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3109-6362","authenticated-orcid":false,"given":"Youngmee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Miami  Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Society AC. \u201cCancer Facts and Figures \u201d (2025)."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/hea0001187"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27677"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010018\u20104146\u20109"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010010\u20101035\u20102"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920\u2010018\u20100977\u20109"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.04.024"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1521\u20100391.2011.00126.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1744\u2010859x\u201012\u201030"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000593"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29040"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2020.1800009"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30428"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ncc.0b013e3182747b75"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.8.1184"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000160459.78182.d9"},{"key":"e_1_2_9_18_1","article-title":"The Role of PTSD Symptom Clusters and Criterion in Predicting Future High\u2010Risk Drug and Alcohol Use Among Returning Veteran Men and Women","author":"Livingston N. 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