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

Wang, Ashley W.T.; Bouchard, Laura C.; Gudenkauf, Lisa M.; Jutagir, Devika R.; Fisher, Hannah M.; Jacobs, Jamie M.; Blomberg, Bonnie B.; Lechner, Suzanne C.; Carver, Charles S.; Antoni, Mike

doi:10.1016/j.jpsychores.2018.07.011

Cited by 37 publications

(18 citation statements)

References 34 publications

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“…It is possible that patients with greater levels of NA and disease‐related challenges (eg, patients with mBCa) may benefit the most from such interventions 76 . The current findings suggest that patients with mBCa who report the greatest levels of NA display reduced brain activity in regions that could be modulated by training in stress management that addresses the functions associated with these regions.…”

Section: Discussionmentioning

confidence: 71%

Negative affect and stress‐related brain metabolism in patients with metastatic breast cancer

Reis

Travado

Antoni

et al. 2020

Cancer

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Background Cancer and its treatment represent major stressors requiring that patients make multiple adaptations. Despite evidence that poor adaptation to stressors is associated with more distress and negative affect (NA), neuroimmune dysregulation and poorer health outcomes, current understanding is very limited of how NA covaries with central nervous system changes to account for these associations. Methods NA was correlated with brain metabolic activity using 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT) in several regions of interest in 61 women with metastatic breast cancer. Patients underwent 18F‐FDG PET/CT and completed an assessment of NA using the Brief Symptom Inventory. Results Regression analyses revealed that NA was significantly negatively correlated with the standardized uptake value ratio of the insula, thalamus, hypothalamus, ventromedial prefrontal cortex, and lateral prefrontal cortex. Voxel‐wise correlation analyses within these 5 regions of interest demonstrated high left‐right symmetry and the highest NA correlations with the anterior insula, thalamus (medial and ventral portion), lateral prefrontal cortex (right Brodmann area 9 [BA9], left BA45, and right and left BA10 and BA8), and ventromedial prefrontal cortex (bilateral BA11). Conclusions The regions of interest most strongly negatively associated with NA represent key areas for successful adaptation to stressors and may be particularly relevant in patients with metastatic breast cancer who are dealing with multiple challenges of cancer and its treatment.

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Section: Discussionmentioning

confidence: 71%

Negative affect and stress‐related brain metabolism in patients with metastatic breast cancer

Reis

Travado

Antoni

et al. 2020

Cancer

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“…In terms of the “who” question, we need more information on which subgroups of patients are likely to benefit the most from SM interventions. Although there is evidence that patients with greater cancer‐specific distress, pessimism, and other psychosocial adversity indicators experience the greatest effects of these interventions on psychological adaptation, there is no evidence to date that these psychosocial characteristics can predict the effects of an intervention on biobehavioral and long‐term clinical health outcomes. Beyond psychosocial characteristics, it is also important to explore biomedical (eg, tumor phenotype and immune system status) and sociodemographic factors that can be used to identify which patients are most likely to experience psychological, biobehavioral, and health benefits.…”

Section: Sm and The Immune Processes In Patients With Cancermentioning

confidence: 99%

The impact of psychosocial stress and stress management on immune responses in patients with cancer

Antoni

Dhabhar

2019

Cancer

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200

177

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The range of psychosocial stress factors/processes (eg, chronic stress, distress states, coping, social adversity) were reviewed as they relate to immune variables in cancer along with studies of psychosocial interventions on these stress processes and immune measures in cancer populations. The review includes molecular, cellular, and clinical research specifically examining the effects of stress processes and stress‐management interventions on immune variables (eg, cellular immune function, inflammation), which may or may not be changing directly in response to the cancer or its treatment. Basic psychoneuroimmunologic research on stress processes (using animal or cellular/tumor models) provides leads for investigating biobehavioral processes that may underlie the associations reported to date. The development of theoretically driven and empirically supported stress‐management interventions may provide important adjuncts to clinical cancer care going forward.

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“…Instead, CPSP is heavily influenced by emotional distress, which has led to a general call for ways to target the emotional distress, since this is a modifiable risk factor that could be intervened on ( Jackson et al, 2016 ). In a recent study, those women with the highest level of distress after surgery were those who benefited the most from a psychological treatment ( Wang et al, 2018a , b ). We therefore argue that from a prevention perspective, timing of the intervention is crucial.…”

Section: Peri- and Postoperative Stress – The Crucial Time Just Before During And After Surgerymentioning

confidence: 99%

What Does CATS Have to Do With Cancer? The Cognitive Activation Theory of Stress (CATS) Forms the SURGE Model of Chronic Post-surgical Pain in Women With Breast Cancer

2021

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Chronic post-surgical pain (CPSP) represents a highly prevalent and significant clinical problem. Both major and minor surgeries entail risks of developing CPSP, and cancer-related surgery is no exception. As an example, more than 40% of women undergoing breast cancer surgery struggle with CPSP years after surgery. While we do not fully understand the pathophysiology of CPSP, we know it is multifaceted with biological, social, and psychological factors contributing. The aim of this review is to advocate for the role of response outcome expectancies in the development of CPSP following breast cancer surgery. We propose the Cognitive Activation Theory of Stress (CATS) as an applicable theoretical framework detailing the potential role of cortisol regulation, inflammation, and inflammatory-induced sickness behavior in CPSP. Drawing on learning theory and activation theory, CATS offers psychobiological explanations for the relationship between stress and health, where acquired expectancies are crucial in determining the stress response and health outcomes. Based on existing knowledge about risk factors for CPSP, and in line with the CATS position, we propose the SURGEry outcome expectancy (SURGE) model of CPSP. According to SURGE, expectancies impact stress physiology, inflammation, and fear-based learning influencing the development and persistence of CPSP. SURGE further proposes that generalized response outcome expectancies drive adaptive or maladaptive stress responses in the time around surgery, where coping dampens the stress response, while helplessness and hopelessness sustains it. A sustained stress response may contribute to central sensitization, alterations in functional brain networks and excessive fear-based learning. This sets the stage for a prolonged state of inflammatory-induced sickness behavior – potentially driving and maintaining CPSP. Finally, as psychological factors are modifiable, robust and potent predictors of CPSP, we suggest hypnosis as an effective intervention strategy targeting response outcome expectancies. We here argue that presurgical clinical hypnosis has the potential of preventing CPSP in women with breast cancer.

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

Cited by 37 publications

References 34 publications

Negative affect and stress‐related brain metabolism in patients with metastatic breast cancer

Negative affect and stress‐related brain metabolism in patients with metastatic breast cancer

The impact of psychosocial stress and stress management on immune responses in patients with cancer

What Does CATS Have to Do With Cancer? The Cognitive Activation Theory of Stress (CATS) Forms the SURGE Model of Chronic Post-surgical Pain in Women With Breast Cancer

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