Patients receiving chemoradiation for cervical cancer are at risk for distress, chemoradiationrelated side-effects, and immunosuppression. This prospective randomized clinical trial examined effects of a complementary therapy, Healing Touch (HT), versus relaxation training (RT) and usual care (UC) for 1) supporting cellular immunity, 2) improving mood and quality of life (QOL), and 3) reducing treatment-associated toxicities and treatment delay in cervical cancer patients receiving chemoradiation. Sixty women with stages IB1 to IVA cervical cancer were randomly assigned to receive UC or 4×/weekly individual sessions of either HT or RT immediately following radiation during their 6-week chemoradiation treatment. Patients completed psychosocial assessments and blood sampling before chemoradiation at baseline, weeks 4 and 6. Multilevel regression analyses using orthogonal contrasts tested for differences between treatment conditions over time. HT patients had a minimal decrease in natural killer cell cytotoxicity (NKCC) over the course of treatment whereas NKCC of RT and UC patients declined Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptBrain Behav Immun. Author manuscript; available in PMC 2011 November 1.

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BACKGROUND: Female veterans are at risk for stress-related physical disorders given unique environmental stress factors, high rates of trauma exposure and a heightened physiologic stress response. There is a need to identify modifiable risk factors which may help minimize the emergence and impact of veteran illness. RESEARCH QUESTION: The present study investigated the contributions of posttraumatic stress symptoms, maladaptive repetitive thought (MRT), depression, childhood trauma and health behaviors (sleep, alcohol use and smoking) to physical disease as operationalized by immune-mediated inflammatory disease occurrence and related functional disability. METHOD: Female Reserve or National Guard veterans (N = 643) enrolled in a parent study conducted through the Iowa City Veteran's Affairs Hospital completed a one-time computer-assisted telephone interview. The current study examined self-report measures of posttraumatic stress symptoms, MRT, depression, childhood trauma, smoking, alcohol use, sleep, inflammatory disease incidence and physical functioning. RESULTS: Proposed models of primary hypotheses were tested using structural equation modeling. Results indicated that both physical disease and functional decline were greater in veterans reporting a history of trauma. Physical disease was associated with greater depression and childhood trauma but lower levels of alcohol use after accounting for covariates. Unexpectedly, greater MRT was associated with less physical disease, although it was only related to disease when depression was included as a covariate. Reduced sleep was linked with greater disease but only when depression was not included in the model, and depression was found to fully mediate the relationship between sleep and physical disease. Smoking and the interaction between posttraumatic stress symptoms and MRT were generally unrelated to physical disease in this sample. CONCLUSIONS: Results of this study are consistent with the hypothesis that physical disorders and related functional decline are greater in trauma-exposed individuals and that depression, childhood trauma, repetitive thought and I am also grateful to my dissertation committee members, Drs. Erika