The Impact of Cognitive Interventions in Treating Depressed Breast Cancer Patients

Abstract

In behavioral medicine, there is adequate support for behavior modification strategies in reducing depression and anxiety in medical patients. There is comparably less support for cognitive interventions with these patients. Treatment outcome studies with cancer patients generally support the efficacy of cognitive-behavioral interventions, but studies have significant methodological limitations. Additionally, cognitive-behavioral therapy for depression incorporates numerous treatment components, and when examining data with nomothetic statistics, important individual differences may go unrecognized. With reference to the sudden gain literature on significant session-by-session treatment gains, this paper highlights the cognitive-behavioral treatment of two breast cancer patients with clinical depression. In addition to positive treatment outcome in which depression was significantly reduced and quality of life and medical outcomes improved, session-based sudden change data suggest that for these cancer patients, cognitive interventions were most significant in accounting for treatment gains. Findings are reviewed in the context of mechanism of change issues in the cognitive-behavioral treatment of depression.

Postsurgical physical activity and fatigue-related daily interference in women with non-metastatic breast cancer

“…Possible scores range from zero to 54, and higher scores are indicative of more severe depression. The HRSD has been used to measure depression in breast cancer patients (Hopko & Colman, 2010; Savard et al, 2006; Park, Lee, Kim, Bae, & Hahm, 2012). It has been found to be a valid and reliable measure in one study of cancer patients (Olden, Rosenfeld, Pessin, & Breitbar, 2009) and has shown good sensitivity, specificity, and predictive validity in another sample of patients with various cancer types (Hopko et al, 2007).…”

IAPT and Long Term Medical Conditions: What Can We Offer?

“…Research evidence suggests that cognitive behavioural therapy (CBT) is effective for people with LTCs regarding both psychological and physical measures, e.g. in pain management (Gatchel, Peng, Peters, Fuchs and Turk, 2007; Morley, Eccleston and Williams (1999); oncology (Hopko and Colman, 2010); and in diabetes management (Ismail, Winkley and Rabe-Hesketh, 2004). However, much of this work focuses on issues such as education of the condition, adjustment, adherence, relationship issues, as well as on depression/anxiety.…”

Developing Services for Patients with Depression or Anxiety in the Context of Long-term Physical Health Conditions and Medically Unexplained Symptoms: Evaluation of an IAPT Pathfinder Site

“…There is an increasing body of evidence that supports the use of adapted CBT across a range of LTCs (Sage, Sowden, Chorlton and Edeleanu, 2008) and MUS (Deary, Chalder and Sharpe, 2007). Specific examples in LTC include CBT for type-2 diabetes (Ismail, Winkley and Rabe-Hesketh, 2004; Wroe, Rennie, Gibbons, Hassy and Chapman, 2015), oncology (Hopko and Coleman, 2010) and multiple sclerosis (Moss-Morris and Wearden, 2013). In MUS, randomized control trials (RCT) in irritable bowel syndrome (Moss-Morris, McAlpine, Didsbury and Spence, 2010) and chronic fatigue (Chalder, Wallace and Wessley, 1997) demonstrate efficacy and particularly the use of pacing as a helpful technique.…”