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Differential psychological effects of cognitive-behavioral stress management among breast cancer patients with high and low initial cancer-specific distress.

Publication ,  Journal Article
Wang, AW-T; Bouchard, LC; Gudenkauf, LM; Jutagir, DR; Fisher, HM; Jacobs, JM; Blomberg, BB; Lechner, SC; Carver, CS; Antoni, MH
Published in: J Psychosom Res
October 2018

OBJECTIVE: Cognitive-behavioral stress management (CBSM) improves adaptation to primary treatment for breast cancer (BCa), evidenced as reductions in distress and increases in positive affect. Because not all BCa patients may need psychosocial intervention, identifying those most likely to benefit is important. A secondary analysis of a previous randomized trial tested whether baseline level of cancer-specific distress moderated CBSM effects on adaptation over 12 months. We hypothesized that patients experiencing the greatest cancer-specific distress in the weeks after surgery would show the greatest CBSM-related effects on distress and affect. METHODS: Stages 0-III BCa patients (N = 240) were enrolled 2-8 weeks after surgery and randomized to either a 10-week group CBSM intervention or a 1-day psychoeducational (PE) control group. They completed the Impact of Event Scale (IES) and Affect Balance Scale (ABS) at study entry, and at 6- and 12- month follow-ups. RESULTS: Latent Growth Curve Modeling across the 12-month interval showed that CBSM interacted with initial cancer-related distress to influence distress and affect. Follow-up analyses showed that those with higher initial distress were significantly improved by CBSM compared to control treatment. No differential improvement in affect or intrusive thoughts occurred among low-distress women. CONCLUSION: CBSM decreased negative affect and intrusive thoughts and increases positive affect among post-surgical BCa patients presenting with elevated cancer-specific distress after surgery, but did not show similar effects in women with low levels of cancer-specific distress. Identifying patients most in need of intervention in the period after surgery may optimize cost-effective cancer care.

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Published In

J Psychosom Res

DOI

EISSN

1879-1360

Publication Date

October 2018

Volume

113

Start / End Page

52 / 57

Location

England

Related Subject Headings

  • Young Adult
  • Stress, Psychological
  • Psychotherapy
  • Psychiatry
  • Middle Aged
  • Humans
  • Female
  • Cognitive Behavioral Therapy
  • Breast Neoplasms
  • Aged
 

Citation

APA
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Wang, A.-T., Bouchard, L. C., Gudenkauf, L. M., Jutagir, D. R., Fisher, H. M., Jacobs, J. M., … Antoni, M. H. (2018). Differential psychological effects of cognitive-behavioral stress management among breast cancer patients with high and low initial cancer-specific distress. J Psychosom Res, 113, 52–57. https://doi.org/10.1016/j.jpsychores.2018.07.011
Wang, Ashley W-T, Laura C. Bouchard, Lisa M. Gudenkauf, Devika R. Jutagir, Hannah M. Fisher, Jamie M. Jacobs, Bonnie B. Blomberg, Suzanne C. Lechner, Charles S. Carver, and Michael H. Antoni. “Differential psychological effects of cognitive-behavioral stress management among breast cancer patients with high and low initial cancer-specific distress.J Psychosom Res 113 (October 2018): 52–57. https://doi.org/10.1016/j.jpsychores.2018.07.011.
Wang AW-T, Bouchard LC, Gudenkauf LM, Jutagir DR, Fisher HM, Jacobs JM, et al. Differential psychological effects of cognitive-behavioral stress management among breast cancer patients with high and low initial cancer-specific distress. J Psychosom Res. 2018 Oct;113:52–7.
Wang, Ashley W. T., et al. “Differential psychological effects of cognitive-behavioral stress management among breast cancer patients with high and low initial cancer-specific distress.J Psychosom Res, vol. 113, Oct. 2018, pp. 52–57. Pubmed, doi:10.1016/j.jpsychores.2018.07.011.
Wang AW-T, Bouchard LC, Gudenkauf LM, Jutagir DR, Fisher HM, Jacobs JM, Blomberg BB, Lechner SC, Carver CS, Antoni MH. Differential psychological effects of cognitive-behavioral stress management among breast cancer patients with high and low initial cancer-specific distress. J Psychosom Res. 2018 Oct;113:52–57.
Journal cover image

Published In

J Psychosom Res

DOI

EISSN

1879-1360

Publication Date

October 2018

Volume

113

Start / End Page

52 / 57

Location

England

Related Subject Headings

  • Young Adult
  • Stress, Psychological
  • Psychotherapy
  • Psychiatry
  • Middle Aged
  • Humans
  • Female
  • Cognitive Behavioral Therapy
  • Breast Neoplasms
  • Aged