stress-cancer - Journal of Consulting and Clinical...

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How Stress Management Improves Quality of Life After Treatment for Breast Cancer Michael H. Antoni University of Miami and Sylvester Cancer Center Suzanne C. Lechner University of Miami School of Medicine and Sylvester Cancer Center Aisha Kazi, Sarah R. Wimberly, Tammy Sifre, Kenya R. Urcuyo, and Kristin Phillips University of Miami Stefan Glu ¨ck University of Miami School of Medicine and Sylvester Cancer Center Charles S. Carver University of Miami The range of effects of psychosocial interventions on quality of life among women with breast cancer remains uncertain. Furthermore, it is unclear which components of multimodal interventions account for such effects. To address these issues, the authors tested a 10-week group cognitive–behavioral stress management intervention among 199 women newly treated for nonmetastatic breast cancer, following them for 1 year after recruitment. The intervention reduced reports of social disruption and increased emotional well-being, positive states of mind, benefit finding, positive lifestyle change, and positive affect for up to 12 months (indeed, some effects strengthened over time). With respect to mechanisms tested, the intervention increased confidence in being able to relax at will. There was also evidence that effects of the intervention on the various outcomes examined were mediated by change in confidence about being able to relax. Thus, this intervention had beneficial effects on diverse aspects of quality of life after treatment for breast cancer, which appear linked to a specific stress management skill taught in the intervention. Keywords: breast cancer, stress management, relaxation training, quality of life Treatment of breast cancer requires significant psychosocial adaptation (Irvine, Brown, Crooks, Roberts, & Browne, 1991; van’t Spijker, Trijsburg, Duivenvoorden, 1997). Symptoms of depression and anxiety are common, along with reports of subjective stress and decrements in sexual and interpersonal functioning (Andrykowski, Cordova, Studts, & Miller, 1998; Carver, Lehman, & Antoni, 2003; Schag et al., 1993; Wimberly, Carver, Laurenceau, Harris, & Antoni, 2005). Conversely, the experience of breast cancer is not wholly negative; many women perceive benefits (as well as threats) in the experience (Taylor, 1983). These include improved personal resources and skills, an enhanced sense of purpose, enhanced spirituality, closer ties to others, and changes in life priorities, collectively termed benefit finding (Lechner & Antoni, 2004; Tomich & Helgeson, 2004). Many factors have been identified as sources of resiliency among women with breast cancer—variables that buffer negative experiences or foster positive ones (Carver, 2005a). Such factors as optimism, effective coping strategies, and social support from one’s spouse or family members yield fewer negative and more positive experiences during treatment and beyond (Alferi, Carver, Antoni, Weiss, & Duran, 2001; Carver et al., 1993; Stanton, Kirk, Cameron, & Danoff-Burg, 2000; Carver et al., 2005). Such work provides a blueprint for psychosocial interventions to enhance
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This note was uploaded on 03/06/2011 for the course PSYCH 212 taught by Professor Dansullivan during the Spring '11 term at NYU.

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stress-cancer - Journal of Consulting and Clinical...

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