Acute stress trajectories 1 year after a breast cancer diagnosis

Pérez, Sandra; Conchado, Andrea; Andreu, Yolanda; Galdón, María José; Cardeña, Etzel; Ibáñez, Elena; Durá, Estrella

doi:10.1007/s00520-015-2960-x

Cited by 20 publications

(16 citation statements)

References 36 publications

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“…The result that most older breast cancer survivors maintain good emotional and cognitive function over time is similar to observations in previous studies modelling trajectories with younger survivors . The fact that one‐third of older survivors had accelerated physical decline is in contrast to results in younger samples and is likely to represent normal aging processes, increased incidence of noncancer chronic illness with advancing age, and possible interactions between chronic illness and cancer and its therapies.…”

Section: Discussionsupporting

confidence: 80%

“…However, most longitudinal studies have studied change at the group level and were not able to identify underlying trajectories in QOL or predictors of subgroups at risk for poor QOL. Further, the few studies examining trajectories have generally only assessed a single aspect of QOL, mostly emotional distress or acute stress symptomatology, and shown distinct trajectories of distress following a breast cancer diagnosis that are consistent with patterns of adjustment to traumatic life events suggested by Bonanno . Some of these studies have also examined the psychological predictors of membership in a trajectory group, concluding that personal and social resources distinguish the different trajectories of the distress of breast cancer patients over time: Women with less self‐esteem and less personal control, lower sense of mastery, less optimism, higher trait and state anxiety or neuroticism, higher focus on symptoms and use of anxious preoccupation and cognitive avoidance as coping strategy, and less social support were more likely to be classified in the higher distress groups.…”

Section: Introductionmentioning

confidence: 98%

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Personality, coping, and social support as predictors of long‐term quality‐of‐life trajectories in older breast cancer survivors: CALGB protocol 369901 (Alliance)

et al. 2017

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Background To determine long-term quality-of-life (QOL) trajectories among breast cancer survivors aged 65+ (older) evaluating the effects of personality and social support. Methods Older women (N = 1280) newly examined with invasive, nonmetastatic breast cancer completed baseline assessments. Follow-up data were collected 6 and 12 months later and then annually for up to 7 years (median 4.5 years). Quality of life was assessed using EORTC-QLQ-C30 emotional, physical, and cognitive scales. Optimism (Life Orientation Test), Coping (Brief COPE), and social support (Medical Outcomes Study) were assessed at baseline. Group-based trajectory modeling identified QOL trajectories; multinomial regression evaluated effects of predictors on trajectory groups. Age, education, systemic therapy, comorbidity, and reported precancer function (SF-12) were considered as controlling variables. Results Three trajectories were identified for each QOL domain: “maintained high,” “phase shift” (lower but parallel scores to “maintained high” group), and “accelerated decline” (lowest baseline scores and steepest decline). Accelerated decline in emotional, physical, and cognitive function was seen in 6.9%, 31.8%, and 7.6% of older survivors, respectively. Maladaptive coping and lower social support increased adjusted odds of being in the accelerated decline group for all QOL domains; lower optimism was only related to decline in emotional function. Chemotherapy was related to physical and cognitive but not emotional function trajectories. Conclusions Personality and social resources affect the course of long-term emotional well-being of older breast cancer survivors; treatment is more important for physical and cognitive than emotional function. Early identification of those vulnerable to deterioration could facilitate clinical and psychological support.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 98%

Personality, coping, and social support as predictors of long‐term quality‐of‐life trajectories in older breast cancer survivors: CALGB protocol 369901 (Alliance)

et al. 2017

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“…“Type C” personality was assessed in one paper that explored predictors of 4 different trauma symptom trajectories in the first year after diagnosis of breast (see explanation above). It predicted a “mild” trajectory.…”

Section: Resultsmentioning

confidence: 99%

“…31 One study reported that specific coping styles predicted cancer patients' trauma symptom trajectories in the first year after diagnosis. 53 This study identified 4 different trajectories of trauma symptoms on the basis of latent growth mixture modelling: resilient (low levels of symptoms at each measurement), delayed-recovered (initial low levels of symptoms that increased and then decreased), mild (initial moderate symptoms slowly decreasing over time), and chronic (persistent high levels of trauma symptoms). Coping by "anxious preoccupation" predicted "mild," "chronic," and "delayed-recovered" symptom trajectories.…”

Section: Self-esteemmentioning

confidence: 99%

Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature

et al. 2018

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ObjectiveWhy some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer‐term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later.MethodsA systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty‐nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence.ResultsThere was no consistent evidence that demographic, clinical, or social factors reliably predicted longer‐term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer‐term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta‐analytic techniques.ConclusionsThis review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed.

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“…Clinicians and researchers agree about the potentially traumatic impact of the illness, and many studies have shown high levels of cancerrelated psychologically based suffering in a substantial proportion of patients, even though only a minority develops a clinical or subclinical form of posttraumatic stress disorders (PTSDs) as defined by Diagnostic and Statistical Manual of Mental Disorders (5th ed. ;DSM-5;American Psychiatric Association [APA], 2013;Mehnert & Koch, 2008;Mitchell et al, 2011;Pérez et al, 2016). From this point of view, the study and implementation of research and intervention aimed at taking care of psychopathology reported by patients with cancer has become an area of fundamental et al, 2012).…”

mentioning

confidence: 99%

EMDR and CBT: A Comparative Clinical Study With Oncological Patients

Faretta¹,

Borsato

Civilotti

et al. 2016

J EMDR Prac Res

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Research in clinical psycho-oncology is becoming an area of key importance in investigating the effects of the interventions of support and/or psychotherapy with patients. This study was conducted with the aim of evaluating the effectiveness of the eye movement desensitization and reprocessing (EMDR) approach compared to a non–trauma-focused cognitive behavioral therapy (CBT) intervention. There were 11 male and 46 female participants, with mixed cancer diagnoses. Thirty-one subjects received EMDR therapy, and 26 received CBT for 12 sessions of 60 minutes each. The Symptom Checklist-90-R (SCL-90-R), COPE inventory, and Davidson Trauma Scale (DTS) were administered at three different times (T0, before intervention; T1, after the sixth session; and T2, after the 12th session); the Karnofsky Performance Status was administered at T0 only. In the EMDR group, a significant improvement was reported for the following 11 of the 17 dependent variables: COPE subscales, Avoidance Strategies and Positive Attitude; all three DTS subscales, Intrusion, Avoidance, and Hyperarousal; and 6 SCL-90-R subscales. In the CBT group, a significant improvement was reported for the following 4 of the 17 dependent variables: COPE subscales Positive Attitude and Transcendent Orientation; two DTS subscales, Intrusion, and Avoidance, with no improvement on any of the SCL-90-R subscales. This innovative study shows the value of trauma-focused treatment for patients with cancer and allows important preliminary suggestions on the usefulness of applying EMDR therapy in an oncological setting, although further research in this context is still needed.

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Acute stress trajectories 1 year after a breast cancer diagnosis

Cited by 20 publications

References 36 publications

Personality, coping, and social support as predictors of long‐term quality‐of‐life trajectories in older breast cancer survivors: CALGB protocol 369901 (Alliance)

Personality, coping, and social support as predictors of long‐term quality‐of‐life trajectories in older breast cancer survivors: CALGB protocol 369901 (Alliance)

Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature

EMDR and CBT: A Comparative Clinical Study With Oncological Patients

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